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Crohn's Disease Forum » Treatment » Humira/Adalimumab » What is the effect of Humira without Azathioprine


12-13-2014, 08:00 PM   #1
Matrix
 
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What is the effect of Humira without Azathioprine

Hi

I should start Humira in a few weeks,
I think that most people are using Humira with Azathioprine.

I'm azathioprine intolerant (same for Mercaptopurine),

So I'm wondering what happen when you don't take both together !?

Is Humira less effective without Azathioprine ? or it will not last as long as it should ? or you just have more chance to stay in remission when you take both of them?

thanks !
12-13-2014, 08:07 PM   #2
Clash
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There were some studies awhile back that showed humira in combination with Imuran, 6mp or methotrexate had efficacy at preventing antibodies to the humira. Some people require combo therapy to treat there CD as well. But there are a number of people that do fine for years on just a biologic.
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Clash
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C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara


Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira
12-14-2014, 01:12 AM   #3
theOcean
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Like Clash said, many people do fine on just a biologic! It really depends on your case, and why you needed to be on combination therapy -- if it was to prevent build-up of antibodies, or if it's because you need both to keep your Crohn's in remission. I'm a case where I need to be on both Humira and an immunosuppressant, or I start getting symptoms again, but my case is also pretty severe.

If you are someone who starts getting symptoms again when you go off of it, you could look into Methotrexate, which is different from 6mp/Imuran while still being an immunosuppressant. You probably wouldn't have the same intolerance to it.
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Diagnosis: Fistulizing Crohn's, 2011 (originally Dx as Ulcerative Pancolitis)
Past Medication: Pentasa, Remicade, Prednisone, Imuran
Current Medication: Humira (biweekly), 100mg 6mp
Unrelated Medication: 36mg Concerta, 75mg Pregabalin
Currently: In remission!
12-14-2014, 02:54 AM   #4
Scaryman
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Question is have you ever had a biologic? Methotrexate in my case was prescribed to handle the anti bodies that the body develops against the biologic. ( I was on Remicadee at one point and rejected it.)
With MTX and Humira the adjustment period was rough for me. From Foliculitis to no energy, passing out at work ( I worked with family at the time, so not a big deal.) But it's worth the roughs pot I went through. I am 18 pounds over weight and healthy.
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Diagnosed 2003
5-ASA- failed
Imuran-failed with a strange reaction-paralysis
Remicade- failed with infusion reaction.
Mesalamine-another failure
Entecourt - fail- no help.
currently on Methotrexate 25mg and Humira combo.
Folic Acid Supplement
Hyclosomine,Ultram,vicoden for pain as needed
Extended right Hemocolectomy 5/24/13 Univ.Of Chicago
11/7/13- small crohns ulcer at surgical site (active).
12-15-2014, 08:34 PM   #5
Matrix
 
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Like Clash said, many people do fine on just a biologic! It really depends on your case, and why you needed to be on combination therapy -- if it was to prevent build-up of antibodies, or if it's because you need both to keep your Crohn's in remission. I'm a case where I need to be on both Humira and an immunosuppressant, or I start getting symptoms again, but my case is also pretty severe.

If you are someone who starts getting symptoms again when you go off of it, you could look into Methotrexate, which is different from 6mp/Imuran while still being an immunosuppressant. You probably wouldn't have the same intolerance to it.
Question is have you ever had a biologic? Methotrexate in my case was prescribed to handle the anti bodies that the body develops against the biologic. ( I was on Remicadee at one point and rejected it.)
With MTX and Humira the adjustment period was rough for me. From Foliculitis to no energy, passing out at work ( I worked with family at the time, so not a big deal.) But it's worth the roughs pot I went through. I am 18 pounds over weight and healthy.
OK ! thanks everyone !

I'm just out of my 3rd surgery, and it's to prevent the next one
My Dr told me that I should try to take Methotrexate for the first 6 months with Humira.

How long for adjustment the period ? thanks
12-15-2014, 09:52 PM   #6
Polaris
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There were some studies awhile back that showed humira in combination with Imuran, 6mp or methotrexate had efficacy at preventing antibodies to the humira. Some people require combo therapy to treat there CD as well. But there are a number of people that do fine for years on just a biologic.
Interesting, thank you for sharing. I've been on biologics only for the last 2 years and built up tolerance first to Remicade, and now I suspect the same for Humira (currently trying to get a blood test to find out). My GI tried 6mp but I was intolerant to it (extreme nausea/vomiting).
12-16-2014, 10:49 AM   #7
theOcean
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Interesting, thank you for sharing. I've been on biologics only for the last 2 years and built up tolerance first to Remicade, and now I suspect the same for Humira (currently trying to get a blood test to find out). My GI tried 6mp but I was intolerant to it (extreme nausea/vomiting).

Remicade is much easier to build up a tolerance to because it's made from mouse protein... Humira is a humanized protein (as are most other biologics now) so it's much less likely with it. Good luck, though!


OK ! thanks everyone !



I'm just out of my 3rd surgery, and it's to prevent the next one

My Dr told me that I should try to take Methotrexate for the first 6 months with Humira.



How long for adjustment the period ? thanks

It takes three months to get to a therapeutic level!
12-16-2014, 07:28 PM   #8
my little penguin
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Antibodies can happen against any of the biologics
The only thing that is higher for remicade is the allergic reaction rate since its derived from murine protein.
Testing can be done to determine if an individual developed antibodies to remicade or Humira.
The presence of antibodies does not mean an allergic reaction will occur.
Also the lack of antibodies doesn't mean an allergic reaction won't occur .
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12-17-2014, 01:12 AM   #9
BayAreaChronie
 
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On humira without azathioprine.
Also my first biologic - never took remicade.
It was suggested at first to go with combo therapy, but i was scared of the side effects with combo and preferred to start with just Humira.
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Diagnosed June 2012 at 24
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Previous meds:
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Omega Red Fish Oil
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Gluten free and dairy free diet
No overly spicy food or acidic food or vegetables unless steamed - a boring, bland diet... where a will personally come out and ask if I am sure I don't want all the sides and sauce that make the dish good to begin with
12-17-2014, 02:17 PM   #10
Pilgrim
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My daughter is about to start Humira and she also had an allergic reaction to Azathioprine. Keep posting and let us know how it goes with the MTX and Humira combo.

I hope it works for you!
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Mom to daughter,age 5, diagnosed at age 3 with Crohn's Disease
Current Treatment: Humira (started 12/2014) moved to weekly injections (07/2015), Back to 50% EN orally. Zinc supplements. Calprotectin through the roof.
Previous Treatment: Azathioprine (discontiued 09/14 due to Pancreatitis) Flagyl, Sulfasalazine, EEN, Iron,Vit D, Zinc, SCD
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Crohn's Disease Forum » Treatment » Humira/Adalimumab » What is the effect of Humira without Azathioprine
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