Would like your opinion on what my sons doctors are suggesting. He wants to discuss changing the present maintenance drug of Myco (cellcept) to Aza on his next appointment this thursday as apparently the Journal of the American Medical Association published article stating a European study has found that to quote

"Although mycophenenolate mofetil is frequently regarded as a potent alternative to azathioprine, we found no evidence to support its use as the initial remission maintenance therapy for patients with ANCA positive vasculitis"

Date of the above article was December 1st 2010 Vol 304, No. 21 so surely this trial information is out of date and consisted of doctors in 42 centres in 11 European countries with overall total of only 156 patients between them, 80 of which took aza and 76 myco.

My son was prescribed myco on his eventual release from long stay in hospital on initial diagnosis in early 2009 and has taken the soluble dosage of 5ml twice daily with no major problems. He had two infusions of Ritux shortly before leaving hospital with a single infusion six months later then no more until two years later when he had further one in Aug 2011 followed by second two weeks later in Sep 2011 when slight rise in blood tests detected although he had no outward symptoms.

Myco appears to be working for him so why change things? His Prednisolone dosage is down to 5mg once daily, this is also soluble as he cannot take solid tablets, so far not found evidence of soluble version of Aza. Also takes Adcal-D3 1500mg chewable twice daily. This drug regime has allowed him to return to work full time since end of 2009, he is only in his mid thirties and I personally am worried that if Aza causes problems he could be back to that terrible time in 2009 when his life hung in the balance for over four weeks!

Any thoughts would be really appreciated.

Rif