Remicade vs. 6MP

Which do you think is better to take if you have to move up from 5asas... and if you don't want to take pred. anymore.

Which has less side effects or less severe... ?


I'd think Rem since it's an immediate kick in...

hm... well all I know is my doc told me a month for 6mp to kick in.... and people on here are saying it can take up to 6 months.... I can't wait that long. I'll give it two months....if not by then... I'm asking for Remicade because I need to keep my job at fulltime.

My GI said that if the 5ASAs fail, he'd suggest I go ahead and use Remicade rather than trying 6MP or Imuran. He thinks that it tends to have a higher success rate and that there is evidence that patients are better off in the long run to just skip the immune suppressants. And honestly, I don't think I'd want to wait for 6MP to kick in, mostly because I'd likely have to be on pred to be able to function until it does, and I'm really hesitant to be on pred much at all.

There's a line of thinking initiated by a Dutch IBD gastro who lectured widely in the U.S. last yr that advises treating patients who don't respond to 5-ASAs with the "big gun" meds instead of steroids. The idea behind that is to bring about remission as quickly as possible & to reduce the chances of flare-ups, in an effort to change the course of IBD before it damages the intestinal organs. At this point in time the top research-oriented gastros conclude that steroids should be avoided in most cases because of their many side effects, especially osteoporosis. / Old Hat (30 yrs with left-sided UC ... [etc.])

6mp did not do it for us, but our research oriented doc.wanted my daughter to stay on it, even when the Remi kicked in. We didn't want to mess with what is working, but her 6mp levels are quite low-at only 50 mg, daily- and she is not at Therapudic levels-just took the expensive Prometheous test. The question is, should she stay on it anyway? There is some research to suggest that it keeps the Remi working longer( a goal for a tough case like this). That said, I don't know what anyone else should do, there is a lot of trial and error with this disease. We wnet down the road quickly from Pred, 5ASA's, 6MP, to the big guns.

Sweetmelody - the lupus like syndrome has been said to go away after stopping the use of Remicade. Just to help ease your fear. Also almost all of the UC meds can increase your chances of some type of cancer but w/o them we're hurting our bodies also so it's kinda like a risk some of us just have to take. What does your doctor say? My doctor waited to put me on Remicade until other drugs didn't seem to be helping me fast enough. I was having my worst flare ever and he said I didn't have the time to wait so we had to start it right then. That was last year so about 5 years after my initial diagnosis I started remicade. I'm happy with it so far. I go see my doctor today and I want to see if some of the issues I'm having are related to remicade but if they're not then I haven't had any problems with it. I just have some random dry patches of skin and sometimes itchy bumps. Also my scalp is itchy. Nothing that I can't handle though. I'd rather have itchiness than UC symptoms! Also I just read a few articles that suggest that remicade in combination with an immunosuppresant like 6mp or Imuran increases the likelihood of remicade working and with less symptoms.