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Azathioprine and the neurologist
  1. Matthew McWilliam,
  2. Usman Khan
  1. Neurology, St George's University Hospital, London, UK
  1. Correspondence to Dr Usman Khan, Neurology, St George's University Hospital, London SW17 0QT, UK; usman.khan4{at}


Neurologists are very familiar with using corticosteroids and are aware of their considerable risk of adverse effects with prolonged use. Thus, we frequently consider alternative immunosuppression or corticosteroid sparing agents. However, unlike other specialties, such as rheumatology, there are few indications for corticosteroid-sparing agents in neurology and so our experience is less extensive; even these indications may reduce further as more disease-modifying treatments become available for neurological conditions. Azathioprine is perhaps the most commonly used corticosteroid-sparing agent in neurology. This review aims to remind neurologists of important aspects of azathioprine prescribing, focussing on enhancing patient safety and clinician confidence in its prescribing.

  • biochemistry
  • clinical neurology
  • liver disease
  • medicine
  • myasthenia

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  • Contributors All authors contributed to the final manuscript and its subsequent revision. UK conceived the idea around the manuscript and both authors contributed to the generation of the manuscript and researching of the ideas contained therein.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed by Jackie Palace, Oxford, UK.