Drug advice please!

[Racylady]

Does anyone know anything about the following drugs:

Rituximab
Cyclosporin
Azathroprine

Any info on any of these would be very useful to me right now. I've done the usual checks on the web but if anyone has any personal experience with them, it would be appreciated.

Thanks.

[ultimasimon]

Racylady said:

Does anyone know anything about the following drugs: Rituximab Cyclosporin Azathroprine

www.rituxan.com/rituxan/index.jsp

www.cambridge-transplant.org.uk/drugs/cyclosporin.htm

Can't find much for Azathroprine as my mate GOOGLE says it too new

[Frik]

Calling a PH GP with a copy of Mimm's

[mechsympathy]

ultimasimon said:

Racylady said: Does anyone know anything about the following drugs: Rituximab Cyclosporin Azathroprine www.rituxan.com/rituxan/index.jsp www.cambridge-transplant.org.uk/drugs/cyclosporin.htm Can't find much for Azathroprine as my mate GOOGLE says it too new

According to the copy of MIMMS sat on my desk (I work in a GP surgery) it's spelt azathioprine.

[WildCat]

All are used to treat arthritis.

Azathioprine - used for rheumatoid arthritis and has effect on the immune system - and care is needed on prescription.

You take it twice daily after food and dose depends on your body weight - takes about 12 weeks before results are noticed.

Side effects - tuimmy upsets, skin rash and hair loss. If you get a sore throat or notice bruises - see your doctor immediately - Liebchen.... as this drug is known to disturb your immune system - und makes you prone to diseases. It interact mit live vaccines - such as MMR, und polio (family should receive inactivated vaccines.)

Affects your blood count - so this will be monitored.

Can increase predisposition to cancers as well.

Does react mit other drugs - but your doctor should know this. OK to take NSAIDs/painkillers und also OK to drink booze in moderation.
if your are pregnant or breastfeeding.

Ciclosporin - either capsule or liquid - this reduces swelling und stiffness. Avoid citrus fruits for at least one hour before you take the dose...this drug does not agree mit citric acids und you will be horribly sick - und doctor will check your kidneys before prescribing this drug - und will test your waterworks before und during treatment. The drug requires constant monitoring because of this side effect..

Known to increase blood pressure und affect kidneys. Also tummy upsets and gum disease. This one causes your hair to grow!


Can be prescribed mit other drugs - usually methotrexate (which interacts mit NSAIDS (non-steroidal anti-inflammatory drugs). You can take painkillers as this drug ist not painkiller.

Like azathioprine - it interacts mit live vaccines.

Und you can drink booze in moderation - but much less if it ist prescribed mit methotrexate
if your are pregnant or breastfeeding.

You can find more detail on the pharmaceutical company websites as well...

rituximab -mabthera) - this ist one of ours! See Roche website. und targets B cells (antibody producing cells) RA ist perceived as T-cell driven disease (T-cells are responsible for the cellualr immune response) but B-cells play part in producing auto-antibodies such as rheumatoid factor und this drug removes the B-cells from the blood und helps eliminate the problem. Ist also prescribed mit methotrexate - but this ist still in trial stage. we do not have sufficient data to know all possible side effects - but are hoping to get a licence to run alongside Phase III trials.

Hence will not be prescribed to treat severe RA und ist not a cure.

Und have tried to keep this simple as possible..

[Racylady]

Thanks very much for that.

WildCat - Do you know what trials have been used for any of these drugs as a treatment for ITP?

[RossMac]

ultimasimon said:

Racylady said: Does anyone know anything about the following drugs: Rituximab Cyclosporin Azathroprine <a href="http://www.rituxan.com/rituxan/index.jsp">www.rituxan.com/rituxan/index.jsp</a> <a href="http://www.cambridge-transplant.org.uk/drugs/cyclosporin.htm">www.cambridge-transplant.org.uk/drugs/cyclosporin.htm</a> Can't find much for Azathroprine as my mate GOOGLE says it too new

Azothioprine has been around for years

Quite a combination - of a CD20 monoclonal antibody (Mabthera/Rituximab) used primarily for NHL, and cyclosporin/Azathioprine (immunosuppressants). The latter two are used in organ transplantation and some haematological indications, RA, uveitis, atopic dermatitis and severe psoriasis. Cyclosporin has been trialed in some autoimmune haematological disorders.

MabThera is also being investigated for use in malignant and non-malignant haematological B-cell disorders including, indolent NHL, aggressive NHL, Waldenstrom’s macroglobulinemia, CLL, SLL, multiple myeloma, ITP, rheumatoid arthritis and post-transplantation lymphoproliferative disorders

I would suggest a friendly call to the Medical Information departments (Roche and novartis) of the manufacturers if you want more info on the specific use in ITP or speak to the haematologist. Even better - trawl the internet and you may find some discussion forums.

If you or someone is being asked to enrol in a clincal trial - read the protocol carefully (placebo arm?).

edited - sorry, notice Azathioprine spelling

>> Edited by RossMac on Thursday 16th December 14:31

[WildCat]

Racylady said:

Thanks very much for that. WildCat - Do you know what trials have been used for any of these drugs as a treatment for ITP?

Azathioprine ist used in the treatment so as to reduce the steroid doseage for some patients. One its actions ist to reduce the activity of the immune system. Because azathioprine cause fewer blood cells to be made (und affects liver on that basis) und interacts mit live vaccines - would only be used in small amount to interact mit a steroid treatment. This ist one of trial I am aware of for azathioprine mit ITP in past und why small dose can be used in the treatment.... ... but my expertise ist mit another area....

But you may find that short spell on steroid/azathioprine treatment may have beneficial effect on return to immunoglobulin treatment - und I think this ist what your specialist is aiming for.

Kineret und rituximab are also immunnomodulators...Kineret has 7% rate of serious infections was observed mit concurrent administration of Kineret und etanercept. but this looking at Mabthera being available on prescription for RA in 2005 at earliest und it has not be compared mit infliximab - Remicade und anakinra - Kineret und etanercept(Enbrel) yet -as it ist too early.

Und ja - Mabthera ist proving useful in combination mit other chemotherapy in treating non Hogkins lymphoma und cancers of the blood. Been around since 1998 in reality und was approved as front line cancer treatment in August...but ist now being investigated for RA, ITP as well.

>> Edited by WildCat on Thursday 16th December 17:28