Question
I was recently diagnosed with spondyloarthritis and I also have myasthenia gravis which has been stable with CellCept and prednisone. The arthritis is not responding despite the doses of prednisone, 25mg/day and my rheumatologist wants to go to one of the TNF’s. My neurologist does not want to stop the cellcept since I have been so stable with it. Are there any contraindications to the use of TNF’s with Cellcept?
Answer
There are no studies that have directly addressed this question, and the combination of a TNF inhibitor and CellCept is not used frequently. I am not aware of any negative reports on the combination. TNF inhibitors have been used with other oral immunosuppressive agents including extensively with methotrexate in RA and Remicade has been used together with Imuran (azathioprine) for inflammatory bowel disease.
