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Should I take infliximab

Hi, I'm new to this forum. I was diagnosed with Crohn's in 1992 when I was 28. I have been fortunate that I've not had surgery. It got close once but then azathioprine was introduced and I've been good in general. My specialist passed away a couple of years ago and I've felt lost. I ended up getting a colonoscopy in January and a specialist I haven't had before said the scope couldn't go further into the small intestine. There's signs of Crohn's and I need to increase my azathioprine to 75mg from 50mg. I had continuous blood test for the tgn level then he said it's fine and we'll meet again in one year. He also explained that if there's obstruction, I will feel it and then, dilation will be needed. After a few months, the hospital got a new specialist to take over my specialist who passed away. He got me an mri. He said I have extensive disease in my small bowel and he wants me to consider infliximab and humira. I don't understand why I should take potent drugs when I feel fine. The previous specialist didn't say anything to this effect. I just need some guidance. Has anybody been in this situation? Should I get second opinion?
On pentasa 2g
And azathioprine 75mg recently from 50mg
 
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If you would like a second opinion then I would go for it. The thing is progression of disease isn't reliant on presentation of symptoms. Chronic simmering inflammation without presentation of outward symptoms can create scar tissue and complications that can cause just as much if not more damage that can inevitably result in surgery.

Inflixamab(remicade) or Humira are very effective at quelling inflammation that could lead to issues such as scar tissue, fistulas, abscesses, obstructions etc.

I hope you find the answers you are looking for.
 
My son was dxed at 15 and his disease was located in the terminal ileum in the small bowel we went straight to remicade at the time of dx. The side effects did scare me but recently we dropped remicade due to it no longer working and I can tell you the fear of uncontrolled disease or under controlled disease terrifies me more.
 
You are so right. I think I'll wait for my next appointment and see what happens. I have lots of questions to ask the specialist and maybe, with what you have experienced, there is no other way but Remicade.
 

theOcean

Moderator
Clash is absolutely right about how inflammation can cause tons of damage, and just because you're not experiencing outward symptoms that doesn't mean that's not what's happening. Some people are even completely asymptomatic, which is almost more dangerous since then it goes undetected for longer.

I've been on Remicade and Humira. Remicade I was allergic to so I wasn't on it for too long, but Humira has been a life-saving medication for me. I don't have any side-effects from it whatsoever.
 
How does Humira work and did you slowly reduce Imuran before going onto different medication?

I feel as if it's catch 22. Remicade = fast healing but promotes scar tissue which is my problem already so how can this be good? If I keep taking only Imuran and I still have strictures, it could be surgery and surgery results in scarring, thus scar tissues developing, back to strictures because of the scar tissues........it's a vicious cycle. Am I stupid to think this way?
 

theOcean

Moderator
Humira is similar to Remicade, except it's a humanized antibody, which is why people are less likely to build antibodies to it. Remicade is an antibody from mouse protein. Remicade is more effective for most people despite that, though.

I don't think Remicade promotes scar tissue, it's just something that isn't healed by anything unfortunately. Imuran slows your immune system and works well to keep you in remission, but Remicade and Humira would also treat the inflammation and be much more effective at getting you into remission. They would also hopefully prevent strictures by preventing and/or treating the inflammation in the first place, which it sounds like Imuran wasn't able to do for you. So it makes sense to add Remicade or Humira.

A number of people actually go on combinations of Imuran/Remicade or Imuran/Humira. I was on both of these combinations as well as both biologics on their own.
 
Thank you to both Clash and The Ocean for your knowledge and input. I truly appreciate this. It's nice to be able to air my concerns and somebody out there is listening. :)
 

theOcean

Moderator
It's no problem! We're here to help and to listen. :) I had to make the decision to go on biologics myself a year and a half ago, so I can imagine what you're going through! In my case it was definitely worth it -- they really saved my life.
 
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