100 mg p/d Azathioprine to treat MS - opinion pls

[mwmarczak]

My wife

We currently live in Kuala Lumpur, MS is not very common in this part of the world, unfortunately there are very few doctors who have experience treating MS.

My wife has quite strong symptons and the doctor that is leading her prescribed Azathioprine to 100mg p/d. That caused some additional symptons, pls see the description below.

We would like to get opinion regarding the current treatment, things to consider and further direction. Big thank you in advance, here is the brief history of symptons and medications that she has been prescribed.



2008:
started getting blurry vision on my left eye

2009:
Blurry vision on my left eye and
started having numbness in my left knee, left body and some tingly feeling in my left hand fingers.

2010:
Got diagnosed with MS in April
Methylprednisolone for one week while being in the hospital
Started Betaferon and continued for one year + Panadol as I was getting high fever on the days I was taking the injection.
Symptoms, such as blurry vision and slight numbness, came and went, did not stay for long

2011:
Stopped Betaferon in June
Slight symptoms such as blurry vision and numbness came and went but nothing major or no relapses

2011 - 2012: No relapses at all
have been doing regular MRI’s and they have been showing good results, no active nor new lesions.

May 2013:
First relapse
Started getting new symptoms:
Double vision
Loosing balance, numbness on the legs (not new). If I am to walk some distance, I need Marcin’s help. And I get tired so quickly. If I sit and get up, I need to stand for a few seconds as if to stretch my legs before I start walking.
Fatigue - needed to crash once or twice a day
Got admitted to the hospital and had a week of Methylprednisolone

July 2013 (Maldives):
2 months after the first relapse in 2013, I had optic neuritis on my right eye.
Around 90% vision was gone
Took Methylprednisolone for 3 days
And after completing the above, took Prednisolone for 11 days
Vision came back

September 2013:
I started feeling weak. My left hand started giving up on me.
my left leg started giving up on me as well I started losing balance
Got admitted and started on Methylprednisolone
Did and MRI before getting admitted - Doctors said there's a possibility that the ms has progressed to something called Nmo, neuro myelitis optica.
Did the anti-body test - came out negative
Started on meds as 3 relapses in 1 year was too much:
50mg of Prednisolone
50mg of Azathioprine
300mg of Calcium
0.25 mcg of Vitamin D
Gastric meds

September 2014:
Have been reducing Prednisolone by 10mg each month
Did MRI beginning of September - results showed no new or active lesions. But the old ones are still there inactive
Started having some bladder issues - bladder retainment and feel the need to go to toilet frequently. Sometimes apply force too.
Took blood test - all good apart from high cholesterol
Showed to Doctor on the 23rd September:
Showed all good but slight balance problem was there
Reduced Prednisolone to 7.5mg - on a plan to reduce it by 2.5mg each month going forward
Increased Azathioprine to 100mg

October 2014:
Weakness around my knees. If I sit and get up, I need to stand for a few seconds as if to stretch my legs before I start walking.
Losing balance a lot, even walking short distances
Bladder problem still exists
blurry vision (started wearing glasses in July 2014; more for computer use)
Body heating up after a short walk and vision goes all blurry / hazy

The main thing we are concerned with is the Azathioprine to 100mg as my wife gets very strong side effects. Any suggestions, points to consider, links, resources will be highly appreciated.

[NHE]

Azathioprine is a strong immunosuppressant that's commonly used in kidney transplants to prevent rejection. There are many side effects and precautions with using azathioprine. You can read more about the drug on the Mayo Clinic's site.

http://www.mayoclinic.org/drugs-supplem ... 067180?p=1

Has your wife tried any of the more commonly used DMDs for MS?