Azathioprine? Latest offering from rheumy - PMRGCAuk

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Azathioprine? Latest offering from rheumy

1602 profile image

Hi everyone

not posted for a while - been a very up and down year so far.

Rheumy saying one thing me doing another. An anguished letter to him in early Sept. resulted in a fast, unexpected appointment. Quick summary: he wanted me to reduce pred faster than I did - mini flares and extra pains in wrists andthumbs. He says that is OA - mind you he also told me the PMR was done with and I have OA in shoulders, neck and hips OOOOOOOOOOOOOO.

Think letter made him jump but he still says PMR runs its course in 18months to 2 years REALLY??? Anyway, I told him that had gone back to 10mg and would stay there for a while to see if system settles again.

He agreed, finally, but still says 10mg too high to stay on long term, does he think I want to stay on this forever?

QUESTION have you any info on AZATHIOPRINE .

That's what he wants to try next. Have had blood tests to check if ok to start this [it will take 3/4 weeks].

Oh CPR 10 [he agrees this is raised and ESR 27 which he claims is in normal range.

Sorry to ramble but am one confused lady.

Nearly forgot - he says PMR is inflammation NOT an autoimmune condition.

Thanks for being there guys.

Cath

10 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Hi Cath

Sorry can’t help on the Azathioprine front.

Would take what he says with a pinch of salt-

PMR gone in 18 months? - yeah right!

ESR 27 normal? - would say on the very high end of normal

CRP 10 - high? - correct

PMR not AI but inflammation?

Would say inflammation caused by an underlying AI illness.

No wonder you’re confused 🤷‍♀️

1602 profile image
1602 in reply to DorsetLady

I agree - oh by the way my GP agrees about the ESR being high xxx

PMRpro profile image
PMRproAmbassador

Time for someone who is rather more up-to-date. It IS inflammatory - but autoinflammatory. Where else does he think the inflammation comes from?

practicalpainmanagement.com...

practicalpainmanagement.com...

vasculitisfoundation.org/ed...

and if he's a medical snob and wants "real" articles there is this:

rmdopen.bmj.com/content/4/1...

As far as I know there is little evidence that aza has a significant effect in PMR. I "failed" methotrexate - there was no suggestion of any point of aza.

1602 profile image
1602 in reply to PMRpro

yes I failed methotrxate too. Thanks for the links I will check them out xxx

I can't help with the Azathioprine for PMR part, but I do know it is a big gun.

I took it along with 100 mg prednisone for 6 mos for autoimmune hepatitis. You might google it and see its applications and side effects--sorry I'm not good at copying links. If methotrexate has side effects, this might be much worse. Good luck dealing with your rheumy.

1602 profile image
1602 in reply to Joaclp

Thanks Joaclp I know it is usually used as an anti-rheumatic drug, the reason he wants me to try it because it "calms down the whole system". Will check on side effects. xxx

I was on azathioprine for 9 weeks 2 years ago the side affects we're awful for me especially on top of all the Prednisolone side affects.At, I came off them did not see the point of taking a drug with all it's own sideaffects to get off another,So just reducing in small amounts very slowly.

1602 profile image
1602 in reply to pakien

Thanks for this pakien - something to consider xxx

I am taking 100mg of Azathioprine at night as a steroid sparer. Compared to Methiotrexate I don’t really suffer any side effects. I have a blood test every six weeks to check on my liver and kidney function. It’s a bit of a balancing act , I didn’t suit high doses of steroids but with no additional medication my CRP and pain levels were high every time I reduced the prednisone dose. It’s not a magic cure taking the Azathioprine but I am making progress, but it has been over 4 years since I was diagnosed. I will add you do have to be aware you are immunosuppressive and be careful with possible hazards such as food poisoning.

I think this one is probably up to you and how much faith you have in your Doctor.

Thanks for this Sallyaches it's nearly 4 years since I was diagnosed, I am reeally not sure about Azathioprine. I'll do more thinking. Don't have in rheumy but my gp is happy about it. Thanks again. Keep going. Cath xxx

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