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Ulcerative Colitis
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Posted 9/4/2012 8:51 PM (GMT 0)
Have an appointment with my GI 9/25. Currently on 60 mg Pred and starting taper. Have had UC for 48 years. GI wants to skip 6mp and go straight to Biologics ie Remicade or Humira. Does anyone have a thought on why not to try 6MP? I have taken a lot of Pred over the past forty years but it has always worked, My thoughts would be at my age while still healthy just go to surgery due to the length of time I have had UC. Any thoughts or input would be appreciated.
Posted 9/4/2012 10:00 PM (GMT 0)
Wow thats a tough question. What else have you taken besides pred? I don't know that I would jump to the big guns if I had been able to control things for 40 years so far without using them. I think I would give 6mp a fair shot. What are your symptoms at this stage? And pardon me for asking your age?
Posted 9/4/2012 10:09 PM (GMT 0)
what is 6mp? compared to biologics?
Posted 9/4/2012 10:24 PM (GMT 0)
     48 yrs...HOLY COW!!!  I would assume most of that time you were in remission?  I should hope you wouldn't be on prednisone all that time.  I suffered with UP (proctitis) for twelve years and became prednisone dependent.  That crap was KILLING me!  It gave me full-blown osteoporosis, uncontrollable high blood pressure and type 2 diabetes.

     I agree with sherbear.  I would try the 6MP before Remicade.  I was on 6MP for seven years.  The first two years I took it I did enjoy remission, but then started to flare yearly, then twice a year...then always in a flare.  I did try Remicade and gave Humira a shot.  I had surgery at age 63.  I am now 66 and feeling great!

Posted 9/4/2012 11:48 PM (GMT 0)
I have been fortunate the past 48 years. sherbear my current age is 65. Over the years I would have 3-4 years of remission then several flares then 1-2 years remision. I used a colorectal surgeon for the first 40 years then he retired and now I am seeing a GI Dr. In my second flare this year. Jan-march Lialda 4.8 mg daily, Rowasa nightly and 60 mg Pred with taper to 0 in march. Had cervical fusion in April. UC flared again in August. Current Meds 4.8 mg Lialda, Rowasa nightly, starting taper from 60 mg Pred, calcium, Metamucil. I have mentioned LDN but Dr not receptive. DX left sided colitis. Thanks for any thoughts!!
Posted 9/5/2012 12:16 AM (GMT 0)
When your in remission do you continue taking meds or do you go off of them. Those are the same meds that I am on for left sided UC. When I am in remission I can go down to 2 Lialda and Rowasa twice weekly. The minute I start to see any symptoms I increase the Lialda to the 4 pills and then do nightly Rowasa. I would also try a probiotic. It may be trial and error as to one that agrees with you. Some on the forum use expensive ones and others don't. It all depends on what helps you but it can be trial and error. My doctor also didn't have a clue as to what LDN is. There is lots of info on the forum about LDN if you put it into a search. Even how to get it prescribed by a phone consultation and then ordering through a compounding pharmacy like Skips Pharmacy. If your interested in it do the search. :)
Posted 9/5/2012 1:07 AM (GMT 0)
I have been on the 4 Lialda since Dec 2011. Did not taper to 2 tabs. I was also still on Rowasa every other night. When the flare started went to every night plus Pred.
Posted 9/5/2012 2:58 AM (GMT 0)
I have been doing pretty well on 6mp so I feel it's a good treatment option. Plus, I see so many people respond to Remicade for a few months or years and then build up antibodies. At that point, they have to try 6mp, alternatives or surgery. It almost seems like 6mp has a better track record if it works for you. One reason GIs sometimes push for biologics is if you're very sick and they don't want you to have to wait to respond with 6mp. Remicade can work VERY quickly for some, almost overnight. 6mp can take months to get into your system.
Posted 9/5/2012 12:11 PM (GMT 0)
I guess it depends on how long you've been flaring, how bad your symptoms are, and if your doc feels like you're in the "danger" zone in terms of being on pred too long. The reason I say this is that Remicade generally kicks in faster than 6MP -- so if you currently need the pred to manage symptoms, you should be able to get off it more quickly than if you start 6MP.

Another option would be to see if steroid enemas work to control symptoms, and use those, not oral pred, while you're waiting for the 6MP to kick in.
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