Imuran and Psoriatic Arthritis

Because it works by suppressing the immune system, Imuran is sometimes used for the treatment of psoriatic arthritis. However, it is not technically approved for this use, and there are risks involved, such as decreased sperm production in men and an increased risk of infection. If you decide to use this drug for psoriatic arthritis, you will likely require extra monitoring.

Treating Psoriatic Arthritis With Imuran

Imuran® (azathioprine) is a medication approved to treat rheumatoid arthritis and to help prevent organ rejection after kidney transplantation. It is sometimes used in an off-label (unapproved) manner for the treatment of psoriatic arthritis. As with many psoriatic arthritis treatments, it carries the risk of some very serious side effects.

Imuran's Role in Psoriatic Arthritis Treatment

Imuran certainly isn't "first line" or "gold standard" therapy for psoriatic arthritis, largely due to the lack of large, well-designed studies of the drug for this use. A somewhat similar medication, methotrexate, is much more commonly used and has more evidence to support its use. However, some people do not respond adequately to methotrexate or cannot take it due to dangerous or intolerable side effects. In such situations, Imuran may be a good alternative.

What Are the Risks?

While Imuran can be a good option for some individuals, it is not without risk. Some of the more important and serious risks of taking Imuran (for any use) include the following:
  • Imuran can decrease the body's ability to produce blood cells, including those that are important for the immune system. It is recommended that you have blood tests frequently (weekly for the first month, twice a month for the next two months, and then at least monthly) to check for these problems.
  • Imuran works by suppressing the immune system. While this is helpful for treating psoriatic arthritis, it also puts you at higher risk for infection. Your body may not be able to fight off infection as well as it should. Let your healthcare provider know if you have any signs of an infection.
  • This medication can increase your risk of certain cancers, especially skin cancer or lymphomas. Let your healthcare provider know if you have any unusual skin changes or other unusual symptoms.
  • Imuran can decrease sperm production in men. This is usually temporary and corrects itself once the drug is stopped. However, this can be quite troublesome for couples who are trying to conceive.
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