Mesalamine intolerant?

I started to flare about a month ago, having increased urgency and blood. I would go to the bathroom and pass gas and pink mucus. I couldn't trust a fart, because I was scared id have an accident. I spoke with my new GI and she told me to start taking the max dose of Lialda ( 4 pills a day) along with canasa at night, and I followed her instructions for about 2 weeks without much improvement. Seemingly out of no where, I was admitted to the hospital with acute pancreatitis. I hadn't drank alcohol in months, nor did they find any gallstones. The doctor consulted a GI (which turned out to be my old GI who diagnosed me) and they agree the pancreatitis was most likely caused by mesalamine. He told me he has seen it before. The only other possibility, which I asked about, was whether marijuana could cause it (I smoke often). To which the doctor told me he absolutely does not think so.

I will be released tomorrow and the GI said he doesn't feel comfortable putting me back on mesalamine, and we will need to look at alternatives. But first, prednisone. He acknowledged its a bad time now with covid - but what can ya do? looks like ill be shopping around for a new regimen.

My question is should I try an immunosuppressant like 6mp or imuran or jump straight to a biologic? Right now, id lean toward remicade, because I have a friend who has done well on it for a decade. I am aware of the risks, but they dont scare me too much, I just want remission. Im not a strong believer in diet and natural stuff.

Which of these medications has the best efficacy in inducing remission?

Thank you everyone, stay safe and healthy!

Sorry for your difficult situation. If you trust your doctor I would follow their advice here. Realize you can reduce your chances of contracting COVID greatly by taking precautions like aggressively disinfecting, washing hands throughout the day and wearing a surgical mask.

Most of the big biologics have around 60-70% chance of helping and around 30% remission rate. These are approximate numbers. Adding 6mp to remicade increases effectiveness. Sorry I don't remember remission rates for 6mp alone but a Google search will give you an idea. I would just focus on getting plenty of sleep and quality nutrition and leave the rest up to your doctor.