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Azathioprine therapy in chronic ulcerative colitis
A H Steinhart1, J P Baker, A Brzezinski
1Department of Medicine, University of Toronto, Ontario, Canada.
Journal of Clinical Gastroenterology
|June 1, 1990
Summary
Azathioprine (Az) therapy is effective and safe for managing chronic ulcerative colitis (CUC) in patients resistant or dependent on steroids. This retrospective study found positive responses in most patients, with minimal side effects and no malignancies observed.
Area of Science:
- Gastroenterology
- Immunosuppressive Therapy
- Inflammatory Bowel Disease
Background:
- Chronic ulcerative colitis (CUC) management often involves corticosteroids.
- Steroid resistance and dependence present significant challenges in CUC treatment.
- Alternative therapies are needed for patients with refractory CUC.
Purpose of the Study:
- To evaluate the efficacy and safety of azathioprine (Az) in patients with chronic ulcerative colitis (CUC).
- To assess Azathioprine's utility in steroid-resistant or steroid-dependent CUC cases.
- To analyze long-term outcomes, including side effects and malignancy incidence.
Main Methods:
- Retrospective analysis of 16 CUC patients treated between 1977 and 1987.
- Open-label administration of azathioprine (mean dose 1.48 mg/kg/d) alongside oral prednisone.
- Indications for Az therapy included inability to wean off steroids, poor steroid response, or steroid toxicity.
Main Results:
- Azathioprine therapy led to a positive response in 15 out of 20 treatment courses (12 out of 16 patients).
- Two patients experienced side effects necessitating azathioprine discontinuation.
- Mean follow-up was 52.6 months, with no reported malignancies during the study period.
Conclusions:
- Azathioprine is an efficacious and safe treatment option for selected CUC patients.
- Azathioprine can be particularly beneficial for CUC patients who are steroid-resistant or steroid-dependent.
- Long-term azathioprine use in this cohort showed a favorable safety profile regarding malignancies.