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Why do people on biologics still take 6mp

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Ulcerative Colitis
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Posted 3/4/2015 1:32 PM (GMT 0)
I noticed that a lol, it has something to do with antibodies? Please explain if you know.

Thanks!
Posted 3/4/2015 1:35 PM (GMT 0)
Yes, it's to help prevent antibodies. I was in 6mp when I started Remicade. I got off 6mp after being on the combo for 6 months or so. My GI didn't see the need for me to be on both, risking possible health complications from a med (6mp) that doesn't work for me anyway. Plus the 6mp/Remicade combo was affecting the nerves of my legs and feet which is a rare complication.
Posted 3/4/2015 1:42 PM (GMT 0)
if you don't take some immune suppressant with Remicade, you are very likely to form antibodies to the humanized mouse proteins. Then Remicade will stop working.

I am not aware that this is necessary with meds based on fully human proteins. Once the biologic kicks in, any immune suppressant could be tapered out.
Posted 3/4/2015 1:49 PM (GMT 0)
Yes, to prevent antibodies. Remicade was the first biologic approved for uc. Remicade is a biologically-engineered protein that is placed in the bloodstream. Remicade is 75 percent human protein and 25 percent mouse protein. The mouse component, makes the remi protein look like a foreign invader, and therefore the immune system creates antibodies in response to a perceived danger. If a patient is on an immunosuppressive medication (aza, 6mp, Imuran) when starting remi, the odds are much lower of the immune system creating antibodies against remi.

One Remi proteins attaches to one tnf-alpha protein making it inert. Tnf-alpha is a used by our immune system to signal "inflammation is needed here", by stopping that signal, inflammation is blocked. But antibodies to remi attach to the remi proteins, preventing remi from doing its intended job...

It is suggested that humira and simponi patients do not need immunosuppressive medications as those biologics are fully humanized (that is no mouse component in the tnf-alpha blocking protein).
Posted 3/4/2015 3:04 PM (GMT 0)
My doctor informed me when I was on both that the risk of cancer goes up with the coupling of 6mp with Remicade. I don't even remember the stats for that though. I think it was still a pretty low percentage. At the time I had to take that risk. I did speak with a girl once who was lucky enough to get Lymphoma from the combo so it does happen.
Posted 3/4/2015 4:04 PM (GMT 0)
" I don't even remember the stats for that though."

Odds of lymphoma for biologic + immunosuppressive meds taken simultaneously 6 in 10,000 (or 0.06 percent).

Odds of lymphoma for immunosuppressive meds only is 4 in 10,000 (or 0.04 percent).

Odds of lymphoma for the average, healthy person on the street on no medications is 2 in 10,000 (or 0.02 percent).
Posted 3/4/2015 5:05 PM (GMT 0)
When I started remicade I was just on it alone. Well that and prednisone because I was in the midst of a horrendous flare. I wasn't given any Imuran or 6mp or even Benadryl or Tylenol like some people get during infusions. Just remicade and remicade alone. After 14 months, I had a little (tiny really in comparison to the previous one) flare. Just a little blood, slight increase in urgency, and inflammation present in my colonoscopy. My doctor feared my body was starting to reject the remicade so he put me on Imuran as well as prednisone to kick the flare. Well Imuran did NOT agree with me so after about a month he told me to stop it. The pred got rid of my flare and I'm still getting remicade and only remicade and I'm doing great! (Knock on wood)
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