Gastroenterologist (Pediatric) | Pediatric Gastroenterology Questions Pediatrician

Taking Humera with Crohn's Disease?

I have a question that's sure to boggle your mind. My 11 year old granddaughter has Crohn's Disease and has been being treated with Humera. Her last two checkups showed she was doing fantastic and the Humera is working as it should. At her last recent checkup, it was found she's doing so well that the doctor determined she could come off of two other medications. Her symptoms have subsided and her doctor was so happy that her blood work looked the best it ever has and showed the Humera is doing its job and doing it well.

Now the crazy part. This doctor (a Pediatric Gastroenterologist) wants my granddaughter to get a second opinion of how another Gastro would handle things IF and WHEN the Humera should ever stop working even though as of today it's working fabulously and shows no signs of any concern. No concerns have ever been discussed! It doesn't make any sense to me. Obviously, I could understand if there was a concern. It's like my doctor telling me to go see a surgeon find out how they would handle things if I were ever to break my leg someday, Why can't the doctor simply call the doctor she wants my granddaughter to see to discuss what they would do? I think if she did, this other doctor would think the present doctor was a crackpot.

I'd be interested in what your take on this is and if this is something you would do at the present time or would you wait until it showed there was a concern? I would think the latter makes complete sense and not when there are no concerns whatsoever. As I said, it doesn't make any sense to me and all it would take is a phone call from doctor to doctor. (and yes, this second doctor has all medical records, but why?)

Female | 11 years old
Complaint duration: 09/28/2021
Medications: Humera
Conditions: Crohns

1 Answer

I agree it is a rather odd recommendation. If the current pediatric GI doctor is not comfortable knowing what to do if your granddaughter ever loses response to Humira, then it doesn't exactly inspire a lot of confidence. You may want to enquire as to how much experience the doctor actually has with IBD. And if the doctor lacks experience then you can simply switch to a GI who specializes in Crohns. There are generally a smaller subset of GIs who are really good at IBD but you need to search for them.

It doesn't seem worthwhile to see another GI just to get an opinion about what to do if something adverse happens in the future.

In general, a patient is remission like your granddaughter just needs to be monitored regularly to make sure the disease does not reappear. Multiple options should be available if she ever had to change medications.