Posted 7/19/2017 7:27 AM (GMT -6)
I'd start the 6MP again, as there's no single UC medication that puts us all into remission. However, a combination of UC medications is often the best choice that produces the best results as they have a cumulative affect.
If you have finished your loading doses of remicade than it is quite common to ask for diagnositic tests to assess whether your new treatment is working. Often health insurance requires this proof to continue prescribing an ongoing maintenance dose of remicade (hey, it's a very, very expensive med so verify it is working). Certainly a colonoscopy isn't your only option in that regard. A flexible-sigmoidoscopy might suffice and is less prep and a quicker procedure (but only goes 1/2 as far). There are non-invasive means of assessing your current inflammation levels, like pill-cams, CRP blood tests, and FCP stool tests all of which can tell you how well you are doing since starting your new treatment.
about 65 percent of UC patients do receive an initial response from remicade, but that's certainly not everyone. Did you receive any response at all (any improvement at all in your symptoms)? If you did receive a response than a dose up to 10mgs per kilogram, every 4 weeks is possible but generally only if your remi concentration test says you are low just before the next infusion. And your remi concentration of 12, is a very good number to have and well within ideal therapeutic (healing) range for that med. They aren't going to max dose your remicade unless there is cause to based on a test. They're not going to max-dose you just to see...
Of those who receive an initial response, only 30 something percent achieve a remission within the trial period of 26-52 weeks (it varies by study). So while remi does work well for some, it is by no means a golden ticket free of UC-symptoms for everyone. You can always give it more time than the studies, and I did achieve a remission at the year mark, myself.
So if you got a response then certainly give yourself more time for continued results. If you did not get a response then I'd consider a different class of biologics like entyvio with a different method of action. But don't write off combination therapy, you could try 6MP, remicade, and asacol just to make sure!