New FDA warnings

I agree with Eva and Wim. Definitely low blow.

Some people don't have the option with treatments, and some do. But the report only shows a total of 43 who got cancer as of 2010. Does that mean within 2010, or as of the last report released. We don't know.

There are still questions that were never answered from the report.

Were lifestyle and history taken into consideration, or simply the disease
What dosage
Was UC or Crohn's more severe: mild-severe vs severe
More women than men
What is the risk ratio? 1 to 3,000? 1 to 1,500?
Is 43 cases too high
Were UCers at a higher risk, or Crohn's
When did they develop lymphoma from the time of starting these medications
Are we at a higher risk of taking either or, or a combination of medications
If possible, should we consider new treatments after this report

Big question I want to know is: How many were researched? 50, 100, 1000?

seconder: Thank you for the response. I agree that no one said anyone was stupid for taking these medications. We all just need to be realistic about the possibility of an increased risk of HSTCL. I don't think the study gives enough information to tell exactly how much of an increased risk it is but it is something to think about.

Believe me, I know the "stupid" comment was made in jest- that's why I so readily agreed! What bothered me was the question as to why people would risk cancer for their colons- obviously, if I had a choice, I'd get rid of the colon! But it's not a simple choice, cancer or my colon??? My decision to take the meds I do weighs on me EVERY SINGLE DAY. And I still feel like I made the right choice, but it does make me think, daily, if I am doing the right thing. It's a hard decision to live with, either way. I also feel the #'s are misleading- I'd like to see actual hard data re. number of people who developed lymphomas, dosages, years on the meds, etc. I don't like to hear other people question my choices, when they really only affect me. And my immediate family, you know? I question my own choice constantly, I just don't need reminding! And yeah, I too can be sensitive!

There's this persistant belief that IBD patients take lower doses of Imuran/ 6MP than transplant patients, but it doesn't to hold true in practice. 

Transplant patients have a loading period where they do take higher doses than IBD patients, but standard practice has transplant patients lower their doses on a maintenance routine after transplantation.  These doses aren't much different than those for IBD patients.  Meanwhile, many IBD patients have higher and higher doses to attempt to control their disease.

More or less across the board, the standard dose is 1-3 mg/ kg.  I would not automatically assume that IBD patients on Imuran/ 6MP who were later diagnosed with cancer were taking higher doses.  Too, one should consider that, as recent research has indicated, most IBD patients discontinue Imuran/ 6MP after a period of time, so long-term compliance is not that great, presumably lowering cancer risk.  Although lack of compliance/ discontinuation of Imuran/ 6MP is a major cause of organ rejection, transplant patients generally do not have the "luxury" of discontinuing their meds thus prolonging their exposure to the drugs.

For UC, Remicade was initially considered a bridge to surgery rather than a maintenance med (and it's still used that way just about everywhere except the US).  Couple that with its relative novelty, and it's not a surprise that there aren't many (any?) studies on long-term use.  Until then, it's wise for the FDA to continue to release updates so that patients can make an informed decision.