Straight to Aza, or try steroids first?

[nitty]

I've just had a review at hospital today, and as I'm not completely controlled on 2.4g of MesavantXL, the next step is to try 4.8g of MesavantXL for 6mths to see if that is enough to reach remission. I'm happy to try that.

We discussed options for what to try if that doesn't work, and the Dr would prefer to go to azathioprine next, as he feels steroids have more side effects and are less likely to induce long-term remission than Aza. I'm a bit hesitant to commit to Aza without trying a course of steroids first as I know someone who just needed a one-off course of pred to sort him out before continuing long-term on 5-ASA.

I just wondered what other people's opinions/experiences were on this.
I know it's a long way off, and may (hopefully) not even be needed, but I'd quite like to get my head round it a bit now while it's fresh in my mind.

Thanks in advance,

Nitty

 

[Jennifer]

I don't take Asa but I do take 6MP and it does help control the disease rather than simply treating the inflammation the disease causes. When the 6MP isn't enough then I go on steroids. Steroids should not be taken long term at high doses yet you can take immune suppressants any amount of time and not have to wean off of them. Its up to you but I'm all for control rather than treat it here and there and have to deal with the side effects of steroids.

 

[nitty]

Thanks Crabby

I guess I'm just scared about the potential consequences of immunosuppression, especially when my symptoms are only mild. If I was having the sorts of trouble that most forum users here have I would probably be jumping at the chance.

 

[Jennifer]

Don't ever want to let it get to that point though. Just my line of thinking though.

 

[nitty]

Yep, I think that's the doc's theory, too. I'll just have to hope the extra mezavant works, and deal with this dilemma if/when it arises.

 

[Grumbletum]

Like you say, hopefully it won't come to that. With mild symptoms, it might be worth trying the steroids first. If a short course might knock the flare on the head, I'd be all for that and keeping the Aza in reserve for - God forbid - a more serious flare.