Azathioprine and methotrexate in multiple sclerosis

Thiopurine Methyltransferase Activity in Spain: A Study of 14,545 Patients

“…They are prescribed in several autoimmune diseases, such as autoimmune hepatitis [1], inflammatory bowel disease (IBD) [2,3], or multiple sclerosis [4], among others. The choice of the dose of azathioprine and 6-MP is generally based on patient weight, with the intention to achieve the highest therapeutic efficacy and, at the same time, to reduce the incidence of adverse effects, although this aim is not always possible.…”

Multifocal inflammatory demyelination in a patient with rheumatoid arthritis and treatment complications

“…Low-dose methotrexate has been found to diminish antigen-stimulated T-cell proliferation [2]. Two placebo-controlled double-blind studies have demonstrated that low-dose oral methotrexate (up to 7.5 mg weekly) may alter the disease course favorably in patients with progressive MS, although the long-term benefits are open to interpretation with some adverse effects [2,6]. Hydroxychloroquine/chloroquine has similar potential immunosuppressive effects including reduction of pro-inflammatory cytokines by macrophages and lymphocytes [7,8].…”

“…Although there are increasing reports that MS develops in patients with RA following anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment [4], the comorbidity of RA and MS in patients with no anti-TNF-alpha treatment has been rarely reported [2,5]. The development of MS after the onset RA is further rare, in the context of the patients being treated commonly with medications such as methotrexate and/or hydroxychloroquine that have potential immunosuppressive effects [2,[6][7][8]. As MS can be clinically silent [9] and autopsy examination of the central nervous system in RA patients is scanty, the association of MS with RA is possibly under-recognized.…”

Combination therapy in multiple sclerosis

“…b) One of the most used immunosuppressants is azathioprine. This combination has been shown to be safe and efficacious by MRI in at least four studies, and some studies showed a reduction in exacerbations and in progression of disability [54][55][56][57][58]. In one study performed by our group [54], the association of IFNB-1b and azathioprine for 2 years resulted in a 59% reduction in the relapse rate, a stabilised MRI lesion load as measured on T2-weighted images, improvements in neuropsychological tests, as well as proving safe.…”