6-mp

I have a call into the GI for Bratcat. When she has seen him in the past he has mentioned that if she flares again, he would want to put her on 6-mp. She had a round of prednisone with last year's flare that worked but he said if she flared again it would mean that she is steroid dependent.

I always thought "steroid dependent" was used to describe someone who's unable to GET OFF steroids without a return of flare symptoms.

Immunosuppressants supposedly can take up to three months to work. Most docs will give pred or some other med to help control symptoms during that time.

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Diagnosed with ulcerative colitis spring 1999

I took 6mp and it only took a week or two to see vast improvement. However, when my blood was tested a month or two later, I had liver inflammation, so had to stop. I'm on Lialda now, along with entocort and am feeling really good so hopefuly will continue to even after I taper the entocort. I like Lialda, because it is just once a day and easier to remember. Good luck!

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- 45 year old; female

You can use the Google search bar up above to find what everyone is saying about 6mp. But for me, this drug has been a good thing for me. I was flaring for about a year and I couldn't get off steroid enemas so that is why the doc put me on it. It took about 7 weeks for me to notice any improvement which is really quite fast in comparison. The good sides? It might make her feel better - no symptoms and allow her to lead a fairly normal life. The bad side? It lowers your entire immune system, then there is a rare potential side affect of Lymphoma. But don't let that frighten you, like I said, it's very rare but it has been reported in some cases so all doctors are supposed to let you know of the risk. In the beginning, if she was to get on it - she may become more fatigued, have headaches, nausea, hair loss........but taken at night lowers the side effects and after the body becomes accustomed to it; it should stop all together.

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Thanks for the feedback. I did speak with the doctor. He wants her to take the hydrocortisone enema in the morning and the rowasa in the evening for the next 3 days. He also wants her to get her bloodwork tomorrow.

He isn't rushing to change her meds yet. He probably will put her on prednisone for a short time (she wasn't on that long before). Hopefully it will jump start her into remission. We just weren't sure if she should start it tomorrow or wait to see if the double dosage of enemas would help.

He does agree that, for the most part, the asacol and rowasa is working. Since this is her first relapse (maybe her last?) the doctor isn't considering her steroid dependent yet.

 

I'm sorry to say that no this probably won't be her last relapse. :( Uc is a highly unpredictable disease that unless she has her colon out it is going to plague thru out her whole life. Hopefully the steroid is only short term and she can get to feeling better.

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Here's some more info on immunosuppresants:

IBD is commonly treated with the immunomodulators azathioprine and its metabolite 6-MP.4 The appropriateness of immunosuppressants in the management of IBD was assessed this year using the RAND method.5 The results of this Italian study show that only azathioprine, 6-MP, and methotrexate are appropriate in the treatment of IBD. In addition, cyclosporine A was found to be appropriate only in severe UC after the failure of steroids.

The only drugs able to modify the disease course are azathioprine, 6-MP, and methotrexate.6 However, these drugs have a slow onset of action and are associated with important side effects in some patients, often necessitating the discontinuation of the drug. Moreover, up to 60 percent of patients do not respond to these drugs long-term. Furthermore, serious drug toxicity leads to cessation of therapy in 9 percent to 25 percent of patients, and there is failure to achieve efficacy in approximately 15 percent of cases.7

Data also suggest an approximate fourfold increased risk of lymphoma in IBD patients treated with azathioprine/ 6-MP.4 The increased risk of lymphoma could be a result of the medications, the severity of the underlying disease, or a combination of the two, the researchers concluded.

Nodular regenerative hyperplasia of the liver (NRH) also can develop in IBD patients treated with azathioprine.8 “Clinicians should be aware of this serious complication which may occur with any of the purine analogues (azathioprine, 6-MP, and 6-thioguanine),” according to the researchers who presented four such cases.