Biologics or Pred ?

After being on 40mg pred for 2 weeks now for the first time, the only side-effects I have experienced are dizziness and occasional heartburn. Going to the doc tomorrow to hopefully start the taper, as I'd say I'm at about 80-90% now.

All aboard the remission train again guys. Great feeling as always, but very frustrating when it resumes it’s ugly head again. Finishing off the Pred now and been doing well for the last 2/3 weeks. Start my biologics treatment infusion next week, so I’m hoping this is the drug that keeps me in remission long term. Just a quick question, I’m currently on 150MG of AZa and have been for years. Never get any side effects and liver count always good on my bloods. Is it safe to be taking so many immunosuppressive drugs like the biologics with the AZa? Or should I speak to my Dr about possibly dropping the AZa if I’m on biologic infusions?

@ipoop, sounds like a plan. Let’s hope the biologics keeps me in remission. Feeling great again and back to my healthy weight and eating like a pig again

It increases your risk of cancer if you're on both. My dermatologist did not like the fact I was on Humira and Imuran and my GI also said he wouldn't plan to keep me on Imuran for long. Imuran was the worst med I've ever taken so I was only on it a month. Your doctor shoudl have discussed the risks with you.

Well, that's not what my doctors have said. I was trying to help tblock.

Post Edited By Moderator (iPoop) : 3/14/2020 11:09:27 AM (GMT-6)

It may be that Sara14 and iPoop are both right.

Yes, according to the NIH, combining anti-TNF with thiopurines does increase the risk of cancer. But NIH also says that, at least for adults, “these risks should be weighed carefully against the substantial benefits offered by these therapies.”

However for children and young adults TNF blockers are classified as ”black box” which is the strongest risk warning that the FDA can impose on a drug.

https://www.ncbi.nlm.nih.gov/pubmed/23470503
There is evidence that use of thiopurines and anti-tumor necrosis factor (TNF) agents is associated with an increased risk of lymphoma, particularly non-Hodgkin's lymphoma in patients with IBD. Hepatosplenic T-cell lymphoma, although rare, also occurs with increased frequency in patients treated with thiopurines and anti-TNF medications, and young male patients with Crohn's disease appear to be at greatest risk.
Furthermore, thiopurines and anti-TNF agents are associated with elevated rates of nonmelanoma skin cancer in non-IBD and IBD patients, and anti-TNF agents may also increase the risk of melanoma.

Rates of abnormal cervical cytology may be elevated by the use of immunosuppressive agents in female patients with IBD.

Although the use of immunomodulators and anti-TNF agents can promote certain types of lymphoma and skin cancer, patients and clinicians should be aware that the absolute rates of these malignancies remain low, and these risks should be weighed carefully against the substantial benefits offered by these therapies.

TNF Blockers Receive Black Box Warning about Risk of Childhood Cancer
https://www.aboutlawsuits.com/tnf-blockers-black-box-cancer-warning-5254/

The TNF blocker cancer black box warning will be added to Abbott Laboratories’ Humira, Johnson & Johnson’s Remicade and Simponi, and Amgen and Wyeth’s Enbrel. The warning will join another black box on TNF blockers that warns of the increased risk of serious fungal infections added in September 2008.
Black box warnings are the strongest risk warnings that the FDA can impose upon a drug.

Post Edited (IamCurious) : 3/14/2020 7:02:01 PM (GMT-6)

No need to panic people, IAC, with bold black box print. There's enough fear already. Luckily you don't need to be on these drugs.

Certainly stay the course for now, and do have a conversation with your gasteroenteroligist the next time you see him/her. I'd ask if the small risks of lymphomas and melanomas are a concern given the number of years you've been on it. You're talking far less than 1% odds of either, but if you're talking decades and decades on it then there's a bit more worry, but not panic by any means. I'd never advice you to stop the med on your own without talking to your doctor 1st and having him/her weigh in. I've been on 6MP and remicade for about 8-years now, and I am not loosing any sleep over it, like you I am a good responder with no blood work problems. As a reasonable precaution, it can't hurt to ask your primary care physician or SO to annually take a look at any moles/freckles/etc on your back and make sure none of them look like melanomas (rather than being round/oval they have weird tree branches), you can do the parts you can see about annually as well.

Remicade is a long infusion -- about 2.5 hrs. Bring something to entertain yourself. I haven't had any side effects at all with the infusion. Some people take premeds like benedryl or tylenol. Just let them know this is your first infusion and they will keep a close eye on you to make sure you don't have any reaction (those are rare).

And be sure to bring hand sanitizer and use it constantly while there! Those centers are good about cleaning and disinfecting the chairs between patients but you just can't be too careful these days!

Let us know how it goes!

Cheers guys. Oh I’m preparing myself, I’m going in with a mask and gloves not taking any risks walking into a hospital especially with how well I feel at the moment. Don’t want to mess that up.

Glad it went well for you! What was it like in the hospital?

I just was able to get permission to move my next infusion to a stand alone facility 1 day early because I didn't want to have to go in a hospital right now. (I only go to the hospital infusion center because they have Saturday and evening hours so I don't have to miss work) Now my next infusion is 4/17.

Good luck! May this be your ticket to remission! 😀

Thanks guys, much appreciated


@ flower girl, I’m already in remission I have been in remission over a month now. The Pred put me in remission. Only reason why I am going down the biologics route is because I been relying on Pred to much as I am flaring every 3/4 months. My doctor wants me In long term remission, hence the biologics route but I am in full remission already


@ stray dog , no I didn’t bother with the pre meds mate. Just went there and hoped for the best lol


@ CCinpa, the Hospital was fine. It was like a morgue, barely anyone there so was very strange. I put my mask and gloves on for extra protection before I reached the ward for the infusions. There was nobody in my ward getting the biologics apart from me. The nurses had gloves etc, was absolutely fine.