Azathioprine? Latest offering from rheumy

[1602]

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

[DorsetLady PMRGCAuk 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 in reply to DorsetLady]

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

[PMRpro Ambassador]

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 in reply to PMRpro]

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

[Joaclp]

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 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

[pakien]

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 in reply to pakien]

Thanks for this pakien - something to consider xxx

[Sallyaches]

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.

[1602]

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