Question on Azathioprine

Hi Friends,

Hope everyone are doing fine. I am posting in long time. I have had scope done yesterday and found mild to moderate inflammation only in transverse colon. Rectum, sigmoid and descending colon healed completely compared to mild to moderate inflammation last time, thanks to enemas. I assume inflammation in transverse colon is due to enemas not reaching there and orals not doing their job. Despite the significant progress my Dr put me on azathioprine as he says having long standing inflammation is not good. But when i googled about azathioprine there are horrible side effects including lymphoma and leukemia. So, my question is how many of you are taking aza and what are the side effects? is it worth taking and benefits outweigh risks?

You should talk to your GI and PCP to get the fullest account of the benefits and risks of Aza. The drug suppresses the immune system in a more generic way than most biologics. Consequently its side effects are potentially greater. Aza will double your lymphoma risk from about 1 in 750 to 2 in 750 if taken over a pre-longed period. 2 in 750 is still a small number. The greatest relative increase is for younger adult males and the greatest absolute risk is for males over the age of 65. Usually the drug is stopped at this stage and replaced with some other safer maintenance therapy.

Many people have had good success with Aza alone or Aza in combination with a biologics. If you need Aza then it is usually the case that Mesalamine / 5ASAs are not needed. Many GIs are now stopping 5ASAs in that case and newer information suggests that Mesalamine has no significant effect at all in Crohns. about 2 in 3 people will be able to tolerate Aza and see a benefit. Aza will suppress the production of white bloods cells in your bone marrow and can cause elevated MCVs in blood tests; a sign that you may be slightly macrocytic anemic. Although the symptoms of such are hardly noticeable for most.

Thank you all for valuable responses. We have decided to up the orals to max before trying aza. My dr given me 6 months time to try this and still finds inflammation in next scope i will be on aza.

I've been on azathioprine for 15 years or so, no side effects except nausea in the first 3 months. It's my life line and I went back on it after my colectomy to control joint and other types of inflammation.