Imuran is powerful and has been proven to cause mucosal healing...seems to stop Crohn's dead in its tracks.
Entocort is powerful but has not been proven to cause mucosal healing...so the question is, does it stop Crohn's dead in its tracks? Nobody knows.
So I can see why many GIs feel it is safer to rely on Imuran to induce and maintain full remission...at a recent conference, a presenter said you might have to stay on it for at least five years. Nobody knows when you can safely stop Imuran.
We haven't chosen Imuran because:
a) sure, it stops Crohn's, but it whacks the body's immune system...my daughter has always been susceptible to infection, so the last thing she needs is her immune system suppressed
b) in fact, the latest research does not support what GIs thought for years -- they thought Crohn's patients had overactive immune systems. instead, it seems they have underactive and inefficient immune systems
c) LDN seems to offer promise as a safer med than Imuran, and preliminary evidence is that LDN does cause mucosal healing, so we are carefully watching those trials
d) we fear bone marrow suppression and all the other side effects -- even mesalamine seemed to exacerbate her propensity toward iron deficiency
Thanks to Entocort, my daughter is living her dream and studying abroad this Fall term. When she returns, we will have to think about doing a SBFT to figure out whether there is any Crohn's activity.