Crohn's Disease and Pregnacy - Great Article for Women with Crohn's Disease

Ladies - Found this article that contains freat info for women as it relates to Crohn's Disease and pregnacy. Good info on what meds to avoid while pregnant with Crohn's as well as other potential risks.

CHROHN'S AND PREGNANCY: In the past, women with Crohn's were counseled against pregnancy. However, current medical management strategies have made childbearing safer for both mother and baby. Some medications are best avoided during pregnancy, but others are considered safe because of their long history of safe use by patients.

Resarch studies have shown that some drugs commonly used for both maintenance therapy and acute flare-ups of Crohn's are safe for pregnant women to use. They include sulfasalazine (Azulfidine), forms of mesalamine (Asacol, Pentasa, Rowasa) and corticosteroids (Prednisone). Other drugs like azathioprine (Imuran, Azasan), adalimumab (Humira), certolizumab (Cimzia) and infliximab (Remicade) appear to be safe to take during pregnancy.

Methotrexate and thalidomide are two immunosuppressive drugs that should not be used during pregnancy as they have an effect on an unborn child. Methotrexate can cause abortion and skeletal abnormalities, and it should be discontinued at least three months before conception. Thalidomide is well known for causing limb defects as well as other major organ complications in a fetus.

The severity of Crohn's symptoms that are present at conception often continue throughout pregnancy. Women are encouraged to get their disease under control and in remission before conception. They can also get their bodies prepared for a pregnancy by increasing intake of folic acid, quitting smoking, getting more exercise and eating healthier.

For women with Crohn's, the biggest factor influencing a healthy pregnancy is the state of disease activity. A planned pregnancy when Crohn's is in remission has the greatest chance for a favorable outcome. To best manage all aspects of your care during and after pregnancy, work carefully with the doctor you're seeing for Crohn's disease as well as your obstetrician and your baby's pediatrician.
BACKGROUND: Crohn's disease is a chronic, long-term illness in which the intestine, or bowel, becomes inflamed. It is part of a group of diseases known as inflammatory bowel disease, or IBD.
Chrones disease can affect any area of the GI tract, but it most commonly affects the lower part of the small intestine, called the ileum.
The swelling extends deep into the lining of the affected organ and can cause pain, fever and diarrhea.

The disease can surface at any age, but it is most common between the ages of 15 and 30. People with Chron's disease experience periods of severe symptoms, followed by weeks or years of remission.

Treatment may include drugs, nutrition supplements, surgery or a combination of these options. The goal is to control inflammation and relieve the symptoms. Treatment can help control the disease by lowering the number of times a person experiences a recurrence, but there is no cure.

For More Information, Contact:Dana Wirth Sparks
Department of Public Affairs
The Mayo Clinic
Rochester, MN(507) 538-0844
Sparks.dana@mayo.edu
http://www.mayoclinic.org

Good Humira Video and Information

Unforunately I was allergic to Humira, but I have heard wonderful things about Humira helping out other Crohn's Disease Patients. Check it out if you are considering Humira.

HUMIRA:
May help people achieve and maintain remission--that is, stop flare-ups for periods of time. In a clinical trial, 3 times as many patients taking HUMIRA experienced remission at 56 weeks versus those taking a placebo.
Can reduce or help stop many Crohn's symptoms, including painful cramps, persistent diarrhea, and fatigue.
Can work fast--many people experience a significant difference in their symptoms in just 4 weeks.
For Crohn's patients, HUMIRA is taken as just one injection every other week, after your initial starting doses.

I just got an email from Abbot Labs listing some of the side effects of Humira:

Possible side effects of HUMIRA:Serious side effects, which sometimes lead to death, have happened in patients taking HUMIRA.
Serious infections. These infections include TB (tuberculosis) and infections caused by viruses, fungi, or bacteria. Your doctor will examine you for TB and perform a test to see if you have TB. If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with HUMIRA and during treatment with HUMIRA. Even if your TB test is negative your doctor should carefully monitor you for TB infections while you are taking HUMIRA. Patients who had a negative TB skin test before receiving HUMIRA have developed active TB. Tell your doctor if you have any of the following symptoms while taking or after taking HUMIRA: cough, low-grade fever, weight loss, or loss of body fat and muscle.
Certain types of cancer. There have been cases of certain kinds of cancer in patients taking HUMIRA or other TNF blockers. Patients with RA, especially more serious RA, may have a higher chance for getting a kind of cancer called lymphoma. Some patients receiving HUMIRA have developed types of cancer called non-melanoma skin cancer (basal cell cancer and squamous cell cancer of the skin), which are generally not life threatening if treated. Tell your doctor if you have a bump or open sore that doesn't heal.
Allergic reactions. Signs of a serious allergic reaction include skin rash, a swollen face, or trouble breathing.
Hepatitis B virus reactivation in patients that carry the virus in their blood. Tell your doctor if you have any of the following symptoms: feel unwell, poor appetite, fatigue, fever, rash or joint pain.
Nervous system problems. Signs and symptoms include: numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
New heart failure or worsening heart failure you already have. Symptoms include shortness of breath or swelling of your ankles or feet, or sudden weight gain.
Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
Call your doctor or get medical care right away if you develop any of the above symptoms. Your treatment with HUMIRA may be stopped.
Common side effects of HUMIRA are: injection site reactions (redness, rash, swelling, itching or bruising), upper respiratory infections (sinus infections), headaches, rash and nausea.

Not so NICE - UK Law Could Potentially Deny Humira and Remicade

Ugh, see below, apparently the National Institute for Health and Clinical Excellence in the UK is trying to stop funding Humira and Remicade:

A woman with a chronic digestive disease fears she could be denied treatment under government plans to control spending on drugs.Ruth Holmes, 54, of Hartree Way, Kesgrave and her son both suffer from Crohn's disease, a condition that can cause symptoms including vomiting, diarrhoea, weight loss and extreme abdominal pain. But she fears she could be denied suitable treatment under proposals by the National Institute for Health and Clinical Excellence (NICE) to stop funding drugs used to treat acute Crohn's disease.

She said: “It is an absolute outrage. There are so many people going to suffer. I do not think the government does enough for people with Crohn's disease. “It is a life-threatening disease. They have got to think of the people who are suffering and the parents who have got to watch their children go through the symptoms.“It is awful to watch and you do not know what to do for the best, and sometimes you are at your wits' end.”

The drugs Remicade and Humira are commonly used for the treatment of severe Crohn's disease, but NICE has conducted a review of the expensive drugs' cost-effectiveness. At the moment, the decision to supply a patient with the drugs is taken by local NHS Primary Care Trusts on an individual basis.

NICE is due to decide whether to make the drugs available to patients all over the country, or to stop providing it altogether, except to those who already receive it.Kristen O'Leary from NICE said it will be a balanced decision so that all patients, no matter where they live in the country, will have the same rights to the drug. Mrs Holmes, who had a bad reaction to Remicade, is currently trialling a new drug, Certolizumab Pegol, at Addenbrooke's Hospital, Cambridge, but she says when she comes off it, Humira will be the only option available to her.She said her 20-year-old son, who does not want to be named, is currently being treated with steroids but will need to transfer to Humira or Remicade at some point.

Mrs Holmes fears if the new guidelines prevent health authorities from supplying the drug to new patients, she and her son will be left with nothing to prevent their pain.She said: “If they can stop the suffering with the drugs, why would they stop funding them? The next step would probably be to go abroad because I am sure they are not holding them back in America .A charity event to raise money in aid of Crohn's disease sufferers will take place at the Waterfront on Friday.

Crohn's Flare Up Again

Man, every time I feel like I just might be getting ahead I seem to flare up. I hate to say it and I know it will disappoint everyone from Dr. Shafran to my wifey but I suck at taking my meds lately. I feel like with the Humira I was doing well and I want to go back on it. But I was having an allergic reaction to Humira. I bring it on myself and I know it, but I am having pain and way too many urgent "movements"! I need to be better about my Pentasa! Ok, short but had to Vent. Keep your heads up guys and gals!

Stem Cell Transplant or Surgery? Meet with Dr. Shafran Tomorrow

to find out...I ran into Ira and Anita on the street today at a St. Patty's Day Parade in Winter Park (a bit early I know). Anyways after reading up on the whole stem cell and Crohn's thing I am nervous as hell for this appointment. However with nothing really working medication wise (Pentasa/6MP, Asacol, Remicade, Humira, etc), I am down to either letting it go until a major flare up, Surgery or this whole Stem Cell Transplant. I will post after I meet with Dr. Shafran and his staff.

Humira Kicking Ass for Abbott

Abbott Laboratories Inc on Wednesday posted a quarterly profit in line with expectations, driven by higher sales of its drugs and medical devices and favorable foreign exchange factors that bolstered overseas revenue.

Abbott posted a fourth-quarter profit of $1.20 billion, or 77 cents per share. That compared with a loss of $476 million, or 31 cents per share, in the year-ago period when the company took charges related to its purchase of Kos Pharmaceuticals.
Excluding special items, Abbott earned 93 cents per share, in line with the company's forecast of 91 to 93 cents per share.

Company revenue jumped 16 percent to $7.22 billion in the quarter, above the $6.96 billion average forecast of analysts polled by Reuters Estimates. Growth would have been 4.5 percentage points less if not for the weak dollar, which boosted the value of sales outside the United States.

The suburban Chicago-based health-care company said global revenue from prescription medicines rose 18.7 percent, fueled by double-digit gains for its Humira arthritis drug, Kaletra HIV treatment and TriCor medicine to lower blood fats called triglycerides.
Abbott, which is based in suburban Chicago, forecast that sales of Humira will rise to $4 billion in 2008 as the injectable drug makes further inroads against Johnson & Johnson's popular Enbrel. All three medicines work by blocking an inflammation-causing protein called tumor necrosis factor.

Global sales of Abbott's medical products, including diagnostics and diabetes-care brands, rose 11.5 percent.