GI suggesting humira over mercaptopurine

Seems the recent trend in Gastroenterology is to limit usage of thiopurines (mercaptopurine/imuran/azathioprine) to only a couple years at most. My last couple gasteroenterolgists have both giving me guff for being on mercaptopurine since 2012, each saying 2-years max. With much soul-searching, I did quit it and flared 6-months later (the average, slow working med, slowly leaves the system). I restarted it when flaring mildly and am back on it today. That doc was very frustrated, said all of his patients except me and one other were able to successfully get rid of thiopurines and remain in a remission. Both doctors said I could stay on mercaptopurine if I signed a waiver, saying we had the talk about the long term risks and decided to go against my doctor's recommendation. Never ended up signing it, ended up moving to another state. New doctor gave me that talk and mentioned a waiver, and then he retired about 6-months later. Seeing a new doctor in Jan/feb, see if he does the same lol.

Mostly docs are worried about the small but cumulative risks of longterm usage of thioprines. That includes skin cancer and lymphoma. The more recent research points at Thiopurines being responsible for those risks and not biologics. So the biologics are therefore safer for longterm usage. That's the thinking at least, so your doctor is certainly following the current thinking on it. Whether you agree or not, is up to you and there's always a waiver to sign and you could stay the course with what you know works.

TNF-alpha blocking biologics, like humira, have a bout a 65% chance of working for you. So there is a risk you could flare by switching and that it might not work for you. Some risk, you'd have to come to terms with and accept if you wanted to go that route.

I'd gather the facts, and do some soul-searching on it. Not an easy decision to make.

And if you want to feed the skeptic within you, visit this link and see if Abbvie (makers of humira) has been bank rolling your doctor with lots of extra dollars: /projects.propublica.org/docdollars/

I've had two gasteros ask me to do this, should I stay on them for more than 2-years. Could be my New England doctors (one in NH and one in VT), not sure if it is wide-spread. More just a release of liability, that you/I understand the longterm risks as discussed with doc and choose to accept them and stay on thioprines indefinitely *shrug*. I did not keep a copy, unfortunately.