Traditionally, 1st class of UC meds was mesalamines (like lialda/rowasa), 2nd class was thiopurines (azathioprine/umran or 6MP), and then 3rd class was biologics (remicade/humira/entyvio and for the sake of simplicity xeljanz). Many docs are skipping thiopurines as they take 3-months to work and require ongoing blood monitoring (every 3 months while you are on this med). Thiopurines are simple, generic pills you swallow each day and pretty inexpensive. Whereas Biologics are expensive brandname meds.
The one caveat about
thiopurines is they are known to reactivate latent cancers. Often they talk about
prior melanomas (that is skin cancer) as being a reason not to take these meds. I know you've had prior prostate cancer and I am not sure whether that would be affected by thiopurines, but would be a good question for your doctors.
But is far as what thiopurines do: Thiopurines work by intentionally lowering the White Blood Cell count in your body. When we flare, our WBC count goes through the roof, and WBCs are the immune system's attack-dog, directly causing inflammation which causes the awful UC symptoms we know and loathe. The less WBC we have, the less inflammation can be caused, and the better we feel. However, we still need a safe amount of WBCs to counter common infections, cuts, etc so the blood monitoring is essential (as our WBCs can suddenly drop at any time for unknown reasons while on this med).
But I would at least have the conversation: what about
thiopurines (and know I had a prior cancer)? Good to discuss all possible options and weight the pros and cons of various treatment routes, as part of the process of deciding what's the best path forward or you.
Moderator Ulcerative Colitis
John, UC Proctosigmoiditis in Remission
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, and rowasaDoctor asks me "What does my stool look like?" My response "Pretty much like Omaha Beach on D-Day."
Post Edited (iPoop) : 5/7/2019 10:38:52 AM (GMT-6)