Use of azathioprine in IBD: modern aspects of an old drug

Thiopurines have been considered the reference treatment for patients with steroid-dependent moderate to severe IBD for many years. This has been based on evidence describing the efficacy and safety of azathioprine and mercaptopurine in Crohn's disease (CD) and UC. In CD, efficacy has been established through controlled trials, meta-analyses, cohort studies and data on mucosal healing, as well as in withdrawal studies. A Cochrane meta-analysis concluded that azathioprine and mercaptopurine effectively maintained remission in CD with an OR between 2 and 3 compared to placebo.1 Mucosal healing was initially studied in patients on azathioprine with longstanding steroid-free remission.2 In this setting, full mucosal healing was achieved in 54% of patients with ileitis and 70% with colitis. The majority of the remaining patients had at least partial healing, and only a small minority experienced no healing at all. This healing potential was confirmed in a...
Source: Gut - Category: Gastroenterology Authors: Tags: Crohn's disease Leading article Source Type: research