Is anyone else on azathioprine? Also Arcoxia (etorocoxib)?

[missrat]

I have atypical PMR (i.e. with normal blood results) and also degenerative changes in my spine. I saw my rheumatologist yesterday. Because I have diabetes and hypertension, and because steroids worsen my depression, she feels it is best to give a steroid-sparing medication and slowly reduce my prednisolone to 5mg daily. (I'm currently on 11mg.) She has put me on azathioprine 50mg daily for a week, then increasing to twice daily.

Has anyone else had this and, if so, how did you find it? I will have to have regular blood tests.

She also prescribed etorocoxib. My GP wouldn't give COX-2 inhibitors because of the cardiac risks, but the rheumatologist says that they are increasingly finding that the older NSAIDs also increase the risk and many people only need the COX-2 medication every three days once established, which reduces the risk. She said that if I wanted to change from that I could have meloxicam (also COX-2, but longer-established). I've been asking for that for ages as it works so well on animals! I just have to remember not to ask for Metacam (the veterinary name!)

Well - I must do some cage-cleaning now, and put my latest little pets in a more open hammock so they can't hide! Two of them are really too young to have been homed (only the size of mice) but I'll give them a good diet, as a breeder would. Both of those are wavy-coated - one grey and white and one caramel and white, then I have a semi-hairless girl, white/ivory with black eyes. She's 8-9 weeks and much braver.

[polkadotcom]

I have known one other person on azathioprine but unfortunately for her, it didn't help and she came off it after a few months. I think methotrexate is the most widely used steroid sparing agent, although there is some research being done on leflunomide now.

They are finding now with a lot of the older established drugs that their use has a wider range of effects - the side effects are discovered to be useful with other conditions. I think they are looking at the IL-6 inhibitor drugs too.

I'm another atypical one, missrat. I've never had raised inflammation markers but I was lucky to find a good Rheumy who discounted most of the blood test results in favour of symptoms. I do hope that the new meds work well for you and that your new little playmates also do well!

[Lidybeff in reply to polkadotcom]

I was on MTX for many years, it worked a little but not as much as my Rheumy wanted, that was when she switched me to the azathioprine, which as I said worked like a dream, it was dare I say it a "cure" for me.

After my liver healed the rheumy tried me on APO Leflunomide, after persisting for quite a while it became apparent that it wasn't doing a thing.

At that point I said I did not want to go back on Methotrexate either, because it hadn't worked well before. I was tired and I had had enough.

My PMR is typical in that I have high esr and crp levels, but it is atypical in that it is prednisone resistant. The prednisone does work, but it is rare for me to be able to drop below 10mg, and I still have breakthorugh pain and flares at that dose. Luckily my bone density is ok and my blood pressure is under control, so I can keep taking it. I think that PMR is different for each of us, and esr and crp are not always indicative of pain levels. A wise Rheumy goes by patient pain levels. It is a rotten disease, and I wish you all well in your fight against it. Lizzie.

[Lidybeff]

I was on Azathioprine. It worked like a dream,I was a little nauseous at first on it, but that eased I felt well again. I had energy, my pain eased. I was so happy. However within a few months I received an urgent phonecall from my Rheumy telling me to cease taking it immediately. My blood showed that I had extreme liver toxicity from it, acute hepatitis. I had been having some liver pain, but I was shocked and disappointed at the news. Mostly because it meant I had to stop taking it. It took a long time for my liver to recover. My advice is to insist on lots of regular bloods being done. Mine were being done fortnightly, but it still snuck up on me. Lizzie (diagnosed PMR in 2006 and GCA in 2010).

[missrat in reply to Lidybeff]

That must have been hard. I see my GP on Monday and am going to insist on frequent blood tests.