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6-MP vs. Remicaid

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Posted 3/2/2008 6:57 PM (GMT 0)
Is it the norm to try 6-MP/Imuran before moving on to Remicaid? I see so many people having success with Remicaid and I see that many have tried 6-MP/Imuran first.  It seems there are more possible side effects with 6-MP.  Is Remicaid more safe than 6-MP?
Posted 3/2/2008 8:56 PM (GMT 0)
My doctor said we should try remicaid next when I flare again if Encort doesn't work and I haven't done 6-mp. I got the impression that 6-mp and the others take along time to work and remicaid will actually normally get you out of a flare immediately......
Posted 3/2/2008 10:23 PM (GMT 0)
Traditionally they have done the 6-MP or Imuran before because it's the older drug, so they know more about it and have really long-term information about its effects. Even though the possible side effects from it sound scary, they really aren't very common. Also there's the cost consideration, because we know what's going on with health care costs in this country. My insurance company could have kept me on Imuran for the rest of my life for less than my Remicade infusions for one year. Unfortunately, Imuran wasn't very effective for me.
Posted 3/3/2008 4:14 AM (GMT 0)
As I was flyling back from Denver the other day, I sat next to a very young Pediatrician. He was very sweet, and the folks in the seats in front of us started talking about Arthritis, and one person asked the other that had Arthritis if he was using Remicade. I was so surprised to hear him ask about it, that I said to the nice young Pediatrician, "Gee, I'm on Remicade and surprised to hear it being mentioned!" He said, "Really?" And we started chatting about it. He asked me several questions, and I asked him if he had any children on it. He said, "Yes, I do. I believe it's a very fine line....you can be afraid if there will be side effects, but hey, it's quality of life too." Apparently it is a big debate right now because the docs seem to think it's better to give folks quality of life rather than being in a constant flare, and as he said, are the other meds any better? But as we all know, it doesn't always work for everyone. So, interesting dialogue! Guess that's why I love traveling....I meet such interesting people! :-)
Posted 3/3/2008 5:06 AM (GMT 0)
When it was time for me to move on to the big guns my GI started me on remicade for one or two infusions and then once I was on remicade regularly he added 6-mp to my medication cocktail. I was extremely desperate, and unfortunately neither worked for me.
Posted 3/3/2008 6:45 AM (GMT 0)
I'd go for quality of life any time. Before Remicade, I was so sick I think I'd have had to get better to die. I hope the Remi works for me forever.
Posted 3/3/2008 7:17 AM (GMT 0)
I think they try the 6-MP/Imuran before Remicade for a few reasons. It's oral medication, so you can avoid infusions. It also works via a different mechanism--still immune suppressant, but different pathway, so it's worth a try. I've also been told that it's easier to stop taking 6MP in trying to taper off and stay in remission. My doc called Remicade a very long-term option. With my disease being steroid dependent, but mild to moderate, I think we're both still holding out hope that once I'm out of vet school things might get better.
Posted 3/3/2008 2:40 PM (GMT 0)
Thank you all for the advise. It is only 6:30 here in California. After a long and painful weekend I will be calling my GI as soon as they open. He discussed starting me on 6-MP, but I cannot imagine remaining like this for a few months until it kicks in. I will discuss Remicaid vs. Prednisone with him.  When I saw him last he seemed to want to go the 6-MP route instead of the prednisone. I hope he calls me back today. He sometimes calls back the next day.
Posted 3/3/2008 2:43 PM (GMT 0)
Hey Legalsec, I'm in Sacramento, California...yep it's early! :-) Hope your doc gets back to you asap; no need for you to be feeling poorly.

Posted 3/3/2008 3:01 PM (GMT 0)
Just remember that quality of life for a person with rhuemetoid arthritis is very different than quality of life for a UC patient. Just like some asthma patients and organ transplant patients, prednisone is a needed drug for quality of life. However, for a UC patient some of these drugs aren't needed long term for quality of life. I am very glad that I never had the opportunity to take Remicade for UC and that I ended the battle on 6mp.

Sue
Posted 3/4/2008 3:41 AM (GMT 0)
I saw my GI today. He had me do more labs and a C-Diff. He wants me to start back on prednisone, but wants me hold off for 48 hours until he gets the results of my C-Diff.  He said he will start me on 6-MP next week when all my lab results are back. He wants me to start the prednisone at 60mg for one week then taper down to 40 mg. When I was on prednisone before I tapered by 10 mg each week. Is it okay to go from 60 mg to 40 mg? If I had minimal side effects from the prednisone last time, will it be the same this time around? The only side effects I noticed were night sweats and I had to take benadryl to be able to get 3 hours of sleep. I tapered down without any withdrawls that I noticed. I pray that the 6-MP will put me back in remission and I have no side effects from either the 6-MP or the prednisone.  Thank you all for your input and listening!
Posted 3/4/2008 2:08 PM (GMT 0)
Yes, a taper from 60mg to 40mg is safe. It's only when you get to the lower numbers that it gets dicey.

Sue
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