Azathioprine in MOGAD

Exclusion Criteria

• •Hypersensitivity to azathioprine or steroids
• •Active infections or cancer (including tuberculosis, hepatitis, herpes and VZV)
• •Psychosis not controlled by treatment
• •Seriously impaired bone marrow functions: Lymphocyte count \< 1000/ml and or Polynuclear neutrophil count \< 1500/ml
• •Seriously impaired hepatic functions: ALT and/or AST \> 3N
• •Seriously impaired renal functions: GFR \< 29 ml/min/1.73m²
• •Any live vaccine in the past 3 months or planned during the RCT and RCT+6months
• •Thiopurine methyltransferase (TPMT) phenotype deficient or intermediate, with enzymatic activity \< 16 nmol/h/ml
• •Unable to complete an MRI (e.g. due to pacemaker, severe claustrophobia, hypersensitivity to contrast media, or who lack adequate peripheral venous access)
• •Necessary use of a xanthine oxidase inhibitor (Allopurinol, Oxipurinol, Thiopurinol, Febuxotat,…)
• •Necessary use of angiotensin-converting-enzyme inhibitor, cotrimoxazole, cimetidine and indometacine
• •Necessary use of an aminosalicylate derivates
• •Necessary use of any another immunosuppressive therapy, different than azathioprine, or steroids
• •Necessary use of cytotoxic therapy
• •Necessary use of any other medical illness or disability that, in the opinion of the investigator, would compromise effective trial participation
• •Current enrollment or a plan to enroll in any interventional clinical study in which an investigational treatment or approved therapy is use within 5 half-lives prior to baseline. Participation in a non- interventional study can be allowed as long as this participation does not interfere with this protocol or is not likely to affect the subject's ability to comply with the protocol.
• •For subjects coming back from strongyloidiasis endemic regions, a parasitology screening examination will be performed on faeces, and that appropriate treatment will be performed prior to administration of corticosteroids
• •Patients with Lesch Nyhan syndrome
• •Asian patients (probable mutation of the gene NUDT1)
• •Female subjects who have a positive a positive urinary or blood pregnancy test result, are pregnant or are currently breast feeding
• •Inability to comply with study requirements
• •Person under legal protection or deprived of liberty