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Internal Medicine • Rheumatology • Hematology • Azathioprine • General Rheumatology • Gastroenterology • Neurology • Neuromuscular • Neuro-immunology
Do you discontinue or adjust azathioprine when a patient develops elevated MCV after starting it?
When it seems fairly certain that this is a drug effect is it something that can just be monitored or requires a change in approach?
Answer from: at Academic Institution
Great question, with practical implications for the clinic:
Azathioprine (AZA) is a prodrug that likely exerts its immunosuppressive effects against B- and T-cell function by interfering with purine metabolism through its metabolites (including 6-MP).
Logically, many of the "classic" AZA side effe...
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Answer from: at Community Practice
Interesting discussion but analogously, there are different ways to approach elevated MCV in patients on MTX.
Usually, in patients on AZA, there are alternate immunosuppressant agents to use.