background: I have had Crohn's (ileal and oral) for 20 years, along with psoriasis (plaque and palmar/plantar) and psoriatic arthritis. In recent years, I have been on Humira, with good results but not total remission. In response to a flare several months ago, I went to weekly Humira but was still not fully controlling the disease. We added entocort, and soon I seemed steroid dependent. Whenever I tapered down, I would flare.
My gastroenterologist suggested adding 6-mp. 6-mp helped fairly quickly, and I tolerated it well in general but began to experience some confusion and memory loss. Given the nature of my work, I cannot afford the reduced sharpness I experienced.
My rheumatologist/dermatologist suggested mycophenolate mofetil (MMF) which is another drug which inhibits RNA synthesis in lymphocytes and macrophages. MMF is used more heavily in dermatology than by enterologists. My enterologist was skeptical of trying it in my Crohn's. There is some literature on its use in IBD, but the results are more mixed than 6-mp or AZA. In any case, my other doctor prescribed Myfortic for my psoriatic arthritis. I'm taking 3-4 180mg tablets.
UPSHOT: this is a great drug! For me, it is the "bomb." Almost immediately, my Crohn's symptoms faded, and I was able to discontinue the Entocort almost a month ago. Most significant, my oral inflammation (which had been very recalcitrant to treatment) declined substantially, if not entirely. The oro-facial inflammation had even affected my scalp, my eyes and my capacity to tear. Everything quickly began to improve. I may be able to go back to every-other-week dosing of the Humira at this rate.
So far as side effects are concerned, I'm getting some mild insomnia and that's about it.
Folks who haven't found the right cocktail of immunosuppressants may want to look into Myfortic. It's working so far for me.