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Drugs for Treatment of Ulcerative Colitis in IBD01:29

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Azathioprine for refractory ulcerative proctitis: A retrospective multicenter study.

Anne-Laure Mallet1, Guillaume Bouguen2, Guillaume Conroy3

  • 1Department of Hepato-Gastroenterology, University Hospital of Pontchaillou, Rennes, France.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|January 17, 2017
PubMed
Summary

Azathioprine (AZA) showed limited long-term efficacy in refractory ulcerative proctitis (UP). Only one-fifth of patients achieved treatment success, with many discontinuing AZA due to adverse events or lack of response.

Keywords:
AzathioprineProctitisUlcerative colitis

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Area of Science:

  • Gastroenterology
  • Immunosuppressive Therapy
  • Inflammatory Bowel Disease

Background:

  • The efficacy of azathioprine (AZA) in treating refractory ulcerative proctitis (UP) remains largely unknown.
  • Ulcerative proctitis is a subset of ulcerative colitis affecting the rectum.

Purpose of the Study:

  • To evaluate the long-term efficacy and safety of azathioprine (AZA) in patients with refractory ulcerative proctitis (UP).

Main Methods:

  • Retrospective analysis of 25 patients with refractory UP treated with AZA across three centers (2002-2012).
  • Long-term treatment success was defined by absence of colectomy, anti-TNF therapy, ongoing steroids, AZA withdrawal due to adverse events, and clinical quiescence.

Main Results:

  • Of 21 patients with short-term assessment, 10 showed clinical improvement, while 11 did not respond or discontinued AZA.
  • At a median follow-up of 46 months, only 5 patients (23.8%) achieved long-term treatment success.
  • 15 patients required infliximab therapy, and 3 underwent colectomy.

Conclusions:

  • Azathioprine (AZA) demonstrates limited long-term efficacy in maintaining clinical response in patients with refractory ulcerative proctitis (UP) in a real-world setting.
  • A significant proportion of patients either do not respond to AZA or discontinue it due to adverse events, necessitating further treatment escalation.