CROHN'S DISEASE / ULCERATIVE COLITIS COMMUNITY
difficult case of crohn's ?

difficult case of crohn's ?

age : 21
sex: male

here is my case:
i was diagnosed of crohn's 8 years ago.
first year: i took pentaza ( mezalamine) 500 mg orally and i wasn't responsive even at 8 pills/day.
second and third year i took imuran (azathioprine) 150 mg/ day and i wasn't responsive, then i took a combination of imuran and pentaza and even then i wasn't responsive. i was only responsive on not less than 10 mg/day of prednisone.
i took prednisone for 7 or 8 month and i became corticodependant, so my MD decided to opperate : they took out 22 cm beyond the ileum from the colon.
after the first surgery i continued imuran for 2 years and then i stopped it because i had a major flare up. then i went to a food biotechnologist and made a "food print test" for food allegy and decided to rely on some alternative medicine : omega 3.6,9 vit b12 .... i responded for 6 months and stopped responding for unknown reasons. my MD decided that i start with Humira ( adalimumab) after a complication from my first surgery (intestinal adhesions, 2 years after the first surgery), i took humira for approximately 1 year ( 1 injection every week) but i presented a primary or secondary resistance ( it was difficult to assess it) because almost half of the humira period  i was under predinisone and i faced the same problem which is the difficulty of tapering down my steroids.
1 week ago my MD decided that i need to stop the anti-TNF and to take imuran again ,it is unorthodox, but the the reality is that i'm in lebanon, and in my country we still don't have the newer drugs such as tysabri (natalizumab) or cimzia (certolizumab).
now i am taking 100 mg/day of imuran  and i'm  putting 4g of mesalamine enema every day ( which it actually the most helpful in controlling the urgent symptoms,and vit D supplement ( knowing about the new studies that cholecalciferol has an immune modulatory effect) and all that is in order to taper down my prednisone.

any suggestion or ideas on how to continue or if coming back to imura, but with the new combination, will work ...
anything will be helpful
i'm a senior pharmacy student so you can be as professional as you can in your answer
10x for your time
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