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Crohn's Disease Forum » Treatment » Remicade/Infliximab » Aza or Metho with Remicade


07-14-2010, 11:24 AM   #1
Silvermoon
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Aza or Metho with Remicade

This might be somewhere else in the forms (or the info anyway)...but just got a research article sent to me in one of the medical newsgroups I belong to, so I thought I would post the abstract here (I can't really post the link, as you need to be a member of the newsgroup to see the article ...sowwy ) :

Usefulness of co-treatment with immunomodulators in patients with inflammatory bowel disease treated with scheduled infliximab maintenance therapy.
Sokol H, Seksik P, Carrat F, Nion-Larmurier I, Vienne A, Beaugerie L, Cosnes J.

Saint-Antoine hospital, AP-HP, Université Pierre et Marie Curie-Paris 6, Paris, France.

Abstract
Background and aims Concomitant use of immunosuppressants (IS) with scheduled infliximab (IFX) maintenance therapy for Crohn's disease (CD) or ulcerative colitis (UC) is debated. The aim of this study was to assess whether IS co-treatment is useful in patients with inflammatory bowel disease (IBD) on scheduled IFX infusions. Methods 121 consecutive patients with IBD (23 UC, 98 CD) treated by IFX and who received at least 6 months of IS co-treatment (azathioprine (AZA) or methotrexate (MTX)) were studied. In each patient, the IFX treatment duration was divided into semesters which were independently analysed regarding IBD activity. Results Semesters with IS (n=265) and without IS (n=319) were analysed. IBD flares, perianal complications and switch to adalimumab were less frequently observed in semesters with IS than in those without IS (respectively: 19.3% vs 32.0%, p=0.003; 4.1% vs 11.8%, p=0.03; 1.1% vs 5.3%, p=0.006). Maximal C-reactive protein (CRP) level and IFX dose/kg observed during the semesters were lower in semesters with IS. Within semesters with IS, IBD flares and perianal complications were less frequently observed in semesters with AZA than in those with MTX. In multivariate analysis, IS co-treatment was associated with a decreased risk of IBD flare (OR 0.52; 95% CI 0.35 to 0.79) Conclusion In patients with IBD receiving IFX maintenance therapy, IS co-treatment is associated with reduced IBD activity, IFX dose and switch to adalimumab. In this setting, co-treatment with AZA seems to be more effective than co-treatment with MTX. Benefit of such a combination treatment has to be balanced with potential risks, notably infections and cancers.


Basically, it states that aza seems to work better than methotrexate when being used in combination with Remi for handling different extraintestinal IBD....
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07-14-2010, 11:44 AM   #2
Zalanicht
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Good to know if I go back into a flare I'm already on the Aza and since the severity of the situation before the surgery maybe my GI will start Remi and skip Pred.
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28cm sm and L bowel removed, 200 mg Aza, monthly b12 injection,
calcium + vit d. Enjoying my surgery induced remission!
07-14-2010, 11:52 AM   #3
Procyon
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I also read another article somewhere recently that said aza/6MP promotes better mucosal healing in the intestines than methotrexate. Of course I can't find the article now that I'm trying to find it again though. =/
07-19-2010, 01:12 PM   #4
Walt
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Hi Silvermoon,
As I am on both Remicade and Methotrexate, this is of great interest to me.
I am going to print out the blurb and bring it for discussion with my GI.
I travel to the next city to see him next week.
I feel I get better care at University Hospital there, although the highway is boring.

Thanks for posting this,
be well,
Walt
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currently 'enjoying' Metho, Remi gave me Lupus, Humira pens now weekly - jury still out?
whew, just a little Prednisone?

I'm starting to think Crohn's isn't as much fun as they made it sound in the brochure?

Be who you are and say what you feel,
because those who mind don't matter and those who matter don't mind - Dr. Seuss

A hard road is better than no road.

getting knocked down is nothing.
bouncing back is everything.


in the end, only kindness matters...
07-19-2010, 01:45 PM   #5
Silvermoon
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Hey Walt!

The title of your post says it all, doesn't it.... sooooooo many studies flying around....lol. Even I am having a hard time interpreting and keeping up to all of them.... never mind sorting out the contradictory ones....

In a lot of ways, it is encouraging for me, as I was diagnosed during a time when there wasn't a lot of study gone on with IBD yet, so it's good to see some....

On the other hand, it does get a bit overwhelming at the time, doesn't it!?!

Good luck with your GI... and I hear you regarding the travel... the closest internalist to me is 550km...the closest GI.... 900 km.... Ah the joys of "living in the bush"...lol

Stay well!
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