Thank you for the replies.
Insurance declined Humira and it is now being appealed. The denial was because the insurance matrix indicates we haven't tried everything else first that they require. Not sure what it is we haven't tried that they require. I have tried for two years on Cipro, Flagyl and now a low dose of Xifaxan (insurance did not approve the dose the GI wanted to prescribe). The GI says Xifaxan is a mild drug and doesn't think it will do the trick anyway.
I have not been on anything else. I did propose Immuran, but the GI feels this is an outdated/over used drug that is not as effective. I was also advised that with Immuran, you do not recover from immune suppression like you do from biologics should you need to discontinue them due to cancer; as such, they question whether Immuran is more "safe" than biologics.
I'm struggling with this decision to go with Humira, as is. I was of the mindset all along that I wanted to take this one step up at a time. I was just shown my recent scope images and told that I have some cobblestone inflammation and ulceration with puss. I was also told that the pouch looks older than it should because of these findings, but that it dialates well, no strictures and the pouch body looks good otherwise. Finally, that I should not be thinking about pouch failure based on how things currently look, but that I should consider biologics to heal things. I just felt defeated and resigned/agreed to try biologics now.
The insurance decline and my concerns about biologics have me hesitating once again and wondering if I should consider Immuran. I know some have success with Immuran, but many do not.
Any thoughts would be greatly appreciated.