Switching from 6-MP to a biologic?

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rae88
New Member


Date Joined Mar 2018
Total Posts : 3
   Posted 3/5/2018 11:58 AM (GMT -6)   
Hi all,

I've been on 6-MP for almost 15 years, and in the last decade have developed increasing numbers of irregular moles (aka "dysplastic nevi"), ranging from moderately to severely atypical. I have had almost 20 removed (none of which have come back as cancerous, thank goodness) but I'm only 29 cry and I and my doctor are concerned that to continue on 6-MP may be a bad choice for me when weighing that it might be causing these moles. We have been tracking the studies showing that long-term 6-MP usage can cause an increased risk of basal or squamous cell carcinoma, which was not known about when I started on the drug.

We are currently discussing my coming off of 6-MP and switching to a biologic (Humira, Remicade, etc.) Does anyone have any advice, stories you're able to share of your experience of coming off of 6-MP in general or switching from 6-MP to a biologic specifically? Thank you so much!

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16787
   Posted 3/5/2018 3:11 PM (GMT -6)   
Hi Rae, I have not been on 6MP so I have no experience with it. I have been on Remicade & Humira. Both worked well. Remicade is an infusion med & of course Humira is an injectable. Back when I was on Remicade it was done as an out-patient at the hospital. Humira was much more convenient for me. My advice is try not to get spooked over the potential side effects of either one. The odds are very low & it is finding what works best for you. Educate yourself about the medications above all.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

73monte
Veteran Member


Date Joined Mar 2007
Total Posts : 1961
   Posted 3/5/2018 6:33 PM (GMT -6)   
I'm wondering how well being on 6mp controlled your Crohn's symptoms? Since you've been on it for 15yrs. I would assume that it has worked well for you. Remicade and Humira would definitely be a step up in disease control, but maybe you don't need the heavyweights of the maintenance meds, or at least yet.

What about transitioning to another immuno? You might try methotrexate first. I would also persue trying to get some definitive answers as to whether being on 6mp is actually the cause of the moles.

With immunos, you can go on and off of them at will, so you could always try going to another immuno first to see if the moles stop. Once you make the step to Remicade or Humira, you can't just stop and start them like other meds.

billo
Veteran Member


Date Joined Mar 2006
Total Posts : 568
   Posted 3/8/2018 7:18 PM (GMT -6)   
I'm on Humira and 6mp. I was told that 6mp makes it less likely that I will develop antibodies for Humira

scifigal2k
Veteran Member


Date Joined May 2012
Total Posts : 3464
   Posted 3/8/2018 7:27 PM (GMT -6)   
I switched from Imuran to Remicade when Imuran gave me pancreatitis. I was 25, and I've been on Remicade since (almost 6 years). While biologics are a bit more of a big gun, at your age I might hesitate on switching to MTX. The biggest reason is that it isn't safe to be on if you want to have kids (either man or woman), so if you plan on kids in the next few years, then you would need to switch at that point.
"For this thing I besought the Lord thrice that it depart from me. He said, My grace is sufficient for thee: for my strength is made perfect in weakness. Most gladly therefore will I rather glory in my infirmities; I take pleasure in infirmities, reproaches, necessities, persecutions, distresses, for when I am weak, then am I strong" 2 Cor

gypsyfp
Regular Member


Date Joined Jan 2010
Total Posts : 451
   Posted 3/8/2018 11:00 PM (GMT -6)   
15 years!?!
That's terrible! How did you stand it???
I was only on it for a year and that was bad enough.
That low grade chemo made my hair fall out and made me nauseous for 3 months straight. If I had just one sketchy mole, I would have said, NOPE!
I'll never go on it again. I can't believe your GI never encouraged you to go on a better medication in all that time. Were you really that ok on it or did you just never want to change things up?
Be kind, for everyone you meet is fighting a great battle. -Philo of Alexandria

Live as if you liked yourself, and it may happen. -Marge Piercey

rae88
New Member


Date Joined Mar 2018
Total Posts : 3
   Posted 3/15/2018 8:25 AM (GMT -6)   
I never had any noticeable side effects from the 6MP during the 15 years, and until the past couple years when the potential correlation to basal and squamous cell carcinomas began showing in the literature, we just thought I had Crohn's disease AND my body made weird moles independently of that.

I know I have been very lucky that 6MP didn't cause me any side effects like the nausea or hair loss. I'm concerned that I may not be as lucky with biologic side effects, so I want to make myself very informed about what I could be expecting!

rae88
New Member


Date Joined Mar 2018
Total Posts : 3
   Posted 3/15/2018 8:27 AM (GMT -6)   
Currently it's looking like Humira will be the choice, as it's much more convenient to my lifestyle and schedule. Anything I should know (beyond what I can learn from the website and drug information) especially about personal experiences on the drug, positive or negative, is much appreciated!
29 y/o female living that "How do you stay so skinny??" life

Crohn's Disease diag'd in 2002 at age 14, Osteoporosis since 2017 (Prolia shots every 6 months), Kidney stone 2013, Shingles 2007 & 2016

Meds tried: Asacol 2004-2011, Lialda 2011-2017, occasional Prednisone
Current: 6-mercaptopurine from 2003-present
Daily multivitamin, Caltrate, Iron & Vit D

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16787
   Posted 3/15/2018 10:54 AM (GMT -6)   
Humira has to be refrigerated. I always set my pen out on the counter to get some of the cill off & then would roll the pen between my hands to warm it a little more, lol. My gi approved of this method. I only injected my thighs & would pinch up the skin to inject. This is how the nurse showed me. It will sting for a couple minutes only. I had no issues with it.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums
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