Methotrexate vs. Imuran?

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GDen
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   Posted 7/29/2010 12:53 PM (GMT -7)   
Assuming a patient hasn't taken either drug, anybody know why a GI would choose one instead of the other?
Cimzia, Asacol


Sunaddict
Regular Member


Date Joined Jun 2009
Total Posts : 354
   Posted 7/29/2010 12:59 PM (GMT -7)   
GDen said...
Assuming a patient hasn't taken either drug, anybody know why a GI would choose one instead of the other?

Imuran is a lot easier on your body with a lot less side effects (I currently take 2 tabs to avoid  anti-bodies) but it's not working anymore. Any smart doct IMOP would try you on this first before MX
MX has a lot of side effects, you can't be on it all of your life (no doc would suggest this) and it usually goes with Remicade, Humira...
and also helps with anti-bodies (which causes arthritis)
I hope this helps a little!!

MMMNAVY
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   Posted 7/29/2010 1:12 PM (GMT -7)   
I think some of that might be not exactly the correct info. I know 3 people who have been on MTX for more then 30 years. Granted these people are in their 70/80's, but they are more active then I am. In fact I saw one of them shooting hoops at the VA last Friday. I was completely jealous.

I had no success on azo/imu, remi, humira, even oral mtx, but about 6 months after starting injectable MTX has been the best med for me so far. It is not perfect, but when nothing else even remotely helps...
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

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beave
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   Posted 7/29/2010 3:08 PM (GMT -7)   
GIs tend to prefer starting with Imuran (or 6mp) simply because they have been studied more for treating IBD than methotrexate has, ie, there's a lot of research that has been done on the use of imuran/6mp in IBD, while not as much research has been done on methotrexate and IBD.

At the same time, rheumatologists prefer starting rheumatoid arthritis patients with methotrexate because it has been studied more in that disease.

Of course that begs the question "why has imuran been studied so much more than methotrexate for IBD, and why has methotrexate been studied so much more than imuran for RA?" The answer to that is, well, mostly historical reasons. It just kinda started that way and gained its own momentum from there.

Bammer
Regular Member


Date Joined Mar 2008
Total Posts : 381
   Posted 7/29/2010 6:08 PM (GMT -7)   
GI's have a lot of different approaches in their treatment of Crohn's. First drug ever recommended to me was Remicade but after a lot of consultations (4 GI's and 2 surgeons) and tests had a stricture that I don't think any med was going to take away. Had a resection and have been on MTX (actually before surgery) and ever since. Only drug I have ever been on. No side effects. No inflammation seen on my last ultrasound, ESR was 2 on last bloodwork (if that means anything)? Feel very good.
58 yr. old F dx. CD 07/07
Started weekly methotrexate injections 09/22/08.
Lap assisted sigmoidoscopy done May 11/2009


MMMNAVY
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Date Joined Jul 2006
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   Posted 7/29/2010 8:16 PM (GMT -7)   
beave do you know when azo/im was approved for CD, by the FDA? Because I cannot find it. I think from my research that MTX was approved for use with CD in 1988.

I would agree that most GI's go 6mp, azo/immuran, remi, humira, cimiza, and stick steriods and MTX in there somewhere.


Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


Rider Fan
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Date Joined May 2008
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   Posted 7/30/2010 7:27 AM (GMT -7)   
I don't think aza/6MP is approved for use in IBD. It's used 'off label'. I don't think it was worth the cost to the manufacturer to go through the approval process. Actually if you're correct about MTX, I'm surprised since it's such an old drug I didn't think it would be worth it either.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Reduced gluten and dairy.


Go Saskatchewan Roughriders!


MMMNAVY
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Date Joined Jul 2006
Total Posts : 6927
   Posted 7/30/2010 7:48 AM (GMT -7)   
Do you think because it was orginally a cancer drug that they did that? Because for autoimmune disease they use a 1/30th of the dose.
Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


GDen
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Date Joined May 2009
Total Posts : 703
   Posted 7/30/2010 8:07 AM (GMT -7)   
I think one of Imuran's primary uses is in preventing organ transplant rejection -- it suppresses the immune system and is given in much larger doses than for IBD.
Cimzia, Asacol


Rider Fan
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Date Joined May 2008
Total Posts : 1445
   Posted 7/30/2010 9:17 AM (GMT -7)   
That's right, Navy. They were developed and apprvoved as chemotherapy drugs and it wasn't until much later that they started using them for other indications where immune suppression was desired. There are many drugs that were approved for one indication but are in fact now used for many others. Take Amitriptyline for instance, which is approved as an anti-depressant but is now commonly prescribed off-label for a whole basketfull of things.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Reduced gluten and dairy.


Go Saskatchewan Roughriders!

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