Not necessarily, each patient is different. We see that in ITP, where one patient responds to rituxan or another treatment and another patient with what appears to be very similar ITP, does not respond to the same treatment.
I had no problems with imuran and it did nothing for my lupus or ITP, cellcept didn't do much either, although it did seem to help hold my platelets stable, they were not above 30 with 3000mg of cellcept. Imuran at the highest does didn't even do that and my lupus flared while on both drugs.
Regarding liver enzymes-my Alk phos was elevated with cellcept, but never elevated with imuran, although I was on cellcept longer and began cellcept after almost 20 years of managing autoimmune disease, so it could have been the long term use of toxic drugs.
I spent almost 8 years on cellcept, with elevated Alk phos, but after about a year off cellcept, my alk phos is normal, as are all my liver tests. I guess that means it's reversible, even after almost 30 years of toxic drugs, which should be good news for anyone starting or continuing these drugs.
My lupus was very severe, I had a stem cell transplant for autoimmune disease, so I have had an over load of toxic drugs in my medical history. So far (fingers crossed) no major problems, except for osteoporosis and bone problems due to long term use of steroids. I always kept my steroid dose as low as possible, because I felt they were very damaging to my body, maybe more damaging, which is why rheumatologists call imuran and cellcept "steroid sparing" drugs. Although toxic, maybe not as bad as what steroids do to you.
I would never say one drug is better than another drug when treating autoimmune disease, you just never know who will respond to what and sometimes a patient will not respond to a drug used several years ago, but on repeat trial, they do respond. Sometimes they do respond to a drug, but it stops working and they have to go back to a drug used previously. Alternating treatments to stay one step ahead of autoimmune disease.
I've learned to say "never say never" when treating lupus and other autoimmune diseases.