Remicade and TB

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Regular Member

Date Joined Jul 2008
Total Posts : 36
   Posted 6/7/2009 10:05 AM (GMT -7)   
Last summer, my GI was getting ready to start me on Remicade. I had all of the pre-testing done and lo and behold, I tested positive for TB exposure. I was sent to an infectious diseases doctor who put me on a 9 month course of INH (antiTB drug) to rid my system of it.
I will be finished this drug in a week and will then be free to pursue Remicade again. However, at my last appt. with the infectious diseases doc., I asked him if this now meant that I could not get TB while on Remicade, he said that some people with previous exposure could still develop full blown TB while on Remicade, even if they had taken anti TB drug.
I don't know what to do now. Should I take a chance and hope that everything will be okay while on Remicade or should I not risk it ? I have had severe reactions to other Crohn's drugs so I don't have a lot of options left. I have developed quite severe joint pain in my fingers, hands and knees over the past year. I am currently on Pentasa 4 gm. per day. I don't think it is doing very much to help. I just feel like this 52 year old body can't take much more and I don't want to add TB to the list. Advice would be appreciated. Thanks.

Veteran Member

Date Joined Aug 2007
Total Posts : 1202
   Posted 6/7/2009 12:19 PM (GMT -7)   
I tested positive to TB exposure back in 1990. It was a shock to me, but I took the course of INH and went about my life. Now with all the Crohn's meds and the risk of TB, I get chest x-rays every couple of years. I have not been told that I am still at a risk to develop active TB from that initial exposure. But, I could be exposed again, though I've been told it's less likely that I'd get latent TB at all now.

Personally, I have chosen not to worry about TB. I've been on every TNF and immune modulator available for Crohn's. I just keep a watch with chest x-rays and don't worry about it. There is also a new test for TB - TB Gold - that is more specific about the exposure. I haven't researched it in detail, but I believe it can distinguish between an old/treated exposure and a newer exposure. I've never had the test, so I didn't really pay as much attention.

I figure I live with Crohn's everyday. I need to treat the Crohn's... Sorry you are going through this!
--female dx as UC in '04 (1st symptoms in '03), switched to Crohn's in '05, 1 fistula, crohn's colitis, limited to large intestine  --rejected (reaction/didn't work): Asacol, AZA, 6-MP, MTX, Remicade, Humira, prednisone, Tysabri
--Prochymal in Phase III study (can't wait til it's approved!)
--currently taking methylprednisolone 40mg-taper.  Started Cimzia first dose 2/10/09.  Dx Osteoporosis 10/08 started Forteo 1/27/09

New Member

Date Joined Jun 2009
Total Posts : 7
   Posted 6/8/2009 9:39 AM (GMT -7)   
My husband was exposed to TB in the Army in 2006, but was not treated for the exposure. In Nov. 2008 he was diagnosed with a severe case of Crohn's. He started the INH treatment and began mercaptopurine (6-MP) for the Crohn's. The 6-MP was not working for him, so several months later he ended up in the hospital again due to a DVT in his right leg and the Crohn's was not better (May 09). His GI doc had an infectious disease consultant come talk to him about it (he was 5 months into a 9 month treatment) and they decided that he could go ahead and have Remicade. My husband was a Barnes Jewish in St. Louis (an excellent teaching hospital), so I felt VERY comfortable with them telling us it was OK for him to have Remicade.

His response to Remicade has been great. The next day it cut his bathroom visits in half, but that is not the same for everyone. His GI doc even said he was worried it would not even work on him.

I just wanted you to hear about someone that is in the same situation, but has not had the entire 9 month treatment yet. Good luck with what your decision. I know it can be hard.

Post Edited (KNJ) : 6/8/2009 10:48:40 AM (GMT-6)

Regular Member

Date Joined Jul 2008
Total Posts : 36
   Posted 6/8/2009 10:30 AM (GMT -7)   
Thanks so much to both of you good people who responded to my dilemma.
I feel much better after hearing about your success stories. I probably will try Remicade and just hope for the best !
Thanks again.
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