Hi. I’m new to this forum. I’ve had IBD (probably UC but GI falling it indeterminate colitis based on serology) for over 30 years. I’m relatively controlled on Lialda 4.8 gms a day and I flare for 4-6 months every few years (using Uceris for the last two flares with unclear benefit). I get annual colonoscopies now because of the risk of colon cancer since I’ve had the disease so long and family history. Although I’m essentially symptom free (one bm a day) my histology always shows mild to moderate mucosal inflammation. My GI doesn’t like this because of the risk of colon cancer with chronic inflammation.
So he wants me to start Entyvio to induce histologic remission.
My problem is I’ve been exposed to TB (negative chest X-ray and treated with 6 months of INH per protocol in 2001). We’re worried about
reactivation of TB while on biologics. I cosulted with an infectious disease specialist last year who really wasn’t that helpful (noncommittal).
I don’t know what to do. Should I continue managing the disease and the flares as I’m doing knowing there’s a slightly higher risk of colon cancer (I’m getting annual scopes but the biopsies can easily miss dysplasia)?
Or should I start Entyvio and hopefully go into long term remission despite the risk of reactivating TB and the other risks of immunosuppression?
Thanks in advance for your opinions.
Post Edited (aravista) : 11/24/2017 8:21:43 AM (GMT-7)