Has cyclophosphamide followed by azathioprine stopped being used for the treatment of WG?

[shanat19]

In reading the recent question 'WG remission experiences', I wondered why nobody mentioned azathioprine - I was given azathioprine after being informed that being given cyclophosphamide long term caused more problems than it solved.

Not wanting to show my ignorance, I 'Googled' both azathioprine and rituximab which lead me to the RAVE trial - rituxan.com/wg-mpa/hcp/wg-m... - which seems to indicate that rituximab is more successful than cyclophosphamide followed by azathioprine in treating WG and Microscopic Polyangiitis.

However, this website seems to have a commercial interest in rituximab.

[PatriciaAnn]

Hi Shanat

Azathioprine (or even methotrexate or mycophenolate) are usually classed as maintenance therapy when the cyclo has done the trick. I went onto Mycophenolate after cyclo and then later onto azathioprine and I remain on azathioprine. These drugs are fine for helping to control things once the heavy brigade (cyclo) has done its stuff but often we need something stronger if we relapse.

What we were meaning in the previous posts was that if you have a RELAPSE then the newer treatment is often Rituximab rather than having another series of cyclophosphamide which is very toxic. Rituximab is also used where the other drugs have failed to work for whatever reason.

Sorry if the posts caused confusion.

Pat

[braindamage]

Hi. I was diagnosed with Wg in january 2007 and received 13 cycles of Cyclophosphamide. I was taken off metatrexate in August 2007 as it was causing further renal problems and am now on 175mg Azathioprine daily.

All the best.