My son has not had a fistula in 4 years (that we know of). He had a fistulotomy at that time that fixed it. He also went on methotrexate and his studies were much better in the terminal ileum.
There are cases of HSTL with metho and anti-TNF as well as anti-TNF alone. The majority were with the other meds but that are also more commonly used. I did a federal open records act request to the FDA and have all of the cases from the past 5 years. There were 82 with remicade and 17 with Humira reported to the American FDA. Again, most were in men my son's age with Crohn's disease. I know it is very unlikely but given the prognosis, it is still concerning so I thought entyvio may be a better way to start.
Do you all think Anti-TNF is more effective than entyvio? He has never been on steroids so I was thinking maybe they should do a round of pred if entyvio or humira take a while.
Again, I appreciate your expertise so please let me know your thoughts!