Reply To: cellcept/ cyclosporin/immunosuppressants questions
Hi Lori- I am currently on Imuran 50 mg/day ( azothioprine ) and 20 grams of IVIG every 10 days. I have been on Imuran for approx 18 months. I tried cell cept first but could not tolerate due to side effects. I get no side effects from Imuran but there is a genetic test one should have done prior to starting as some people lack an enzyme to metabolize the drug properly. In my case the decision to add was to try to decrease my dependence on ivig as I was receiving weekly at the time and to decrease relapses which were happening about every 6 months. So far it has been successful. I did maintain the weekly ivig for the 6-9 months while waiting for Imuran to fully kick in. In terms of cancer risk, this was demonstrated in studies at high doses in transplant patients who are on multi drug regimens. At lower doses in autoimmune disease like rheumatoid arthritis and lupus this association is less clear. Also confounding this are that many autoimmune diseases like RA and lupus carry higher cancer risk to begin with and it it helpful to keep in mind that in terms of absolute risks the numbers are still low. I wish you luck with your decision making and wish that none of us had to faced with these choices!