Switching from 6-MP to a biologic?

Hi all,

I've been on 6-MP for almost 15 years, and in the last decade have developed increasing numbers of irregular moles (aka "dysplastic nevi"), ranging from moderately to severely atypical. I have had almost 20 removed (none of which have come back as cancerous, thank goodness) but I'm only 29 and I and my doctor are concerned that to continue on 6-MP may be a bad choice for me when weighing that it might be causing these moles. We have been tracking the studies showing that long-term 6-MP usage can cause an increased risk of basal or squamous cell carcinoma, which was not known about when I started on the drug.

We are currently discussing my coming off of 6-MP and switching to a biologic (Humira, Remicade, etc.) Does anyone have any advice, stories you're able to share of your experience of coming off of 6-MP in general or switching from 6-MP to a biologic specifically? Thank you so much!

I'm wondering how well being on 6mp controlled your Crohn's symptoms? Since you've been on it for 15yrs. I would assume that it has worked well for you. Remicade and Humira would definitely be a step up in disease control, but maybe you don't need the heavyweights of the maintenance meds, or at least yet.

What about transitioning to another immuno? You might try methotrexate first. I would also persue trying to get some definitive answers as to whether being on 6mp is actually the cause of the moles.

With immunos, you can go on and off of them at will, so you could always try going to another immuno first to see if the moles stop. Once you make the step to Remicade or Humira, you can't just stop and start them like other meds.

I switched from Imuran to Remicade when Imuran gave me pancreatitis. I was 25, and I've been on Remicade since (almost 6 years). While biologics are a bit more of a big gun, at your age I might hesitate on switching to MTX. The biggest reason is that it isn't safe to be on if you want to have kids (either man or woman), so if you plan on kids in the next few years, then you would need to switch at that point.

I never had any noticeable side effects from the 6MP during the 15 years, and until the past couple years when the potential correlation to basal and squamous cell carcinomas began showing in the literature, we just thought I had Crohn's disease AND my body made weird moles independently of that.

I know I have been very lucky that 6MP didn't cause me any side effects like the nausea or hair loss. I'm concerned that I may not be as lucky with biologic side effects, so I want to make myself very informed about what I could be expecting!

Humira has to be refrigerated. I always set my pen out on the counter to get some of the cill off & then would roll the pen between my hands to warm it a little more, lol. My gi approved of this method. I only injected my thighs & would pinch up the skin to inject. This is how the nurse showed me. It will sting for a couple minutes only. I had no issues with it.

Take care.