My doc is one of the top in the US as well (I thought that was just my opinion until I talked with some Pharma people and they told me it is fact that he is). Anyway, he does clinical trials and is not afraid to try new and different things. So I knew when I heard him say that the anti-TNFs should be used as monotherapy because of the lymphoma thing that it was serious.
He did mention that there have only been a handful of cases. But stressed that if you can get by with anti-tnf as monotherapy, it should be used as such.
I saw a new GI yesterday and had my first appointment with a Rheumy this morning. Both of them want me on Remicade. The GI wants to keep me on the Imuran at the same time. I mentioned the increased risk of cancer to both of them, and specifically the increased risk when combined with the Imuran to the GI, and they both said that Imuran by itself increases my risk of cancer. Oh joy.
I'm pushing back on the Remicade. I'm just not ready to go there yet. No, my Crohn's isn't controlled at the moment, and yes, the symptoms are unpleasant. But let's give all the other stuff I'm taking a chance to work before pulling out the big guns. I don't want to lose the option of Remicade later on when I may need it more.