Combination Therapy

[COLOR=black]Hello Deem,[/COLOR]
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[COLOR=black]I also am doing a combination therapy. In my case, it is plasmapheresis, prednisone (but not a low dose), and azathioprine. I am not wild about any of these therapies, but without them, I know from experience that I would be a quadriplegic. Given that choice, I’ll deal with the future consequences when they come. [/COLOR]
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[COLOR=black]Usually, when immunosuppressants are prescribed in conjunction with prednisone, it is with the idea that one will need less prednisone for the same result. One reason your neurologist might have started you on azathioprine now is that it takes 8 to 12 months to start to have much effect. In other words, you will have figured out how well you tolerate IVIg and what schedule you are likely to need before the azathioprine really has much effect on your immune system.[/COLOR]
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[COLOR=black]As you have noticed, changing the prednisone dose and gauging its effects is a long process. I am 8 months into my current regimen and we are still adjusting the parameters. I hope to have the parameters dialed in by the end of the year, but I would be surprised it happens much before then. [/COLOR]
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[COLOR=black]As to the side effects, all you can do is be vigilant about them. For prednisone, have your neurologist prescribe famatodine (Pepcid), to prevent excess stomach acid production, and Fosamax, to help prevent osteoporosis. If you have risk factors for diabetes, have your neurologist prescribe a blood glucose monitor. Use a blood pressure monitor. Have a bone density scan every now and then. For azathioprine, stay out of the sun and be vigilant about checking for changes in your skin. [Skin cancer is the most common cancer that azathioprine causes.] If a particular type of cancer is common in your family, make sure you watch for it.[/COLOR]
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[COLOR=black]Godspeed in getting your doses and schedules dialed in.[/COLOR]
[COLOR=black]MarkEns[/COLOR]
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