Starting Azathioprine without prednisolone

[nitty]

After initial success with mesavant, it's apparent that it is no longer keeping my CD at bay and I have accepted that I need to get onto Aza, which my consultant is keen for me to do.

My question is whether I can manage to start Aza without any pred? Having had issues with mild depression in the past I would prefer to avoid pred if possible, and I hope that if I start the aza while my symptoms are managable (currently D approx 3-5 times a day) then I won't need the pred.

Has anyone else started the aza without any steroid support, or is it better to have both no matter what?

 

[David]

People often start Azathioprine without steroids and there is data actually showcasing that it might be a good idea to do exactly that, especially if you've had problems with depression. The "top down" approach will often avoid the use of steroids. The main problem is it can take awhile for the Azathioprine to kick in. If the roles were reversed, I might discuss the idea of going on total enteral nutrition with my doctor to bridge the gap between now and when the Azathioprine hits therapeutic levels in your body.

 

[nitty]

Thanks David,

I'll be contacting my IBD nurse tomorrow, so it'll be interesting to see what she says. Obviously I'll go with whatever they recommend from a safest practise point of view, but it's good to know that steroid-free could be a possible option.