-
Zeitschrift Fur Gastroenterologie Jun 2010
Topics: Adult; Azathioprine; C-Reactive Protein; Cohort Studies; Crohn Disease; Female; Follow-Up Studies; Hemoglobins; Humans; Immunosuppressive Agents; Leukocyte Count; Male; Middle Aged; Recurrence; Risk Factors; Withholding Treatment
PubMed: 20517809
DOI: 10.1055/s-0029-1245226 -
The Journal of Pediatrics Nov 1990During a 6-year period, we treated 21 patients with azathioprine, 2 mg/kg/day, as an adjunct to their customary regimen. Nine patients had ulcerative colitis and 12... (Comparative Study)
Comparative Study
During a 6-year period, we treated 21 patients with azathioprine, 2 mg/kg/day, as an adjunct to their customary regimen. Nine patients had ulcerative colitis and 12 patients had Crohn disease; the patients' ages ranged from 3 to 17 years. The median duration of disease before the start of azathioprine therapy was 2 years, and median follow-up was 2 years. Sixteen patients seemed to respond to azathioprine therapy: six patients in each disease group had complete responses and four patients (one with ulcerative colitis and three with Crohn disease) had partial responses. Two patients with ulcerative colitis and three patients with Crohn disease did not respond. The median time until patients responded was less than 3 months for patients with ulcerative colitis and 4 months for those with Crohn disease. Reduction of corticosteroid dose was possible for all patients who responded to azathioprine therapy. Only minimal side effects were attributable to the drug. We conclude that azathioprine is an effective adjunctive agent for the treatment of inflammatory bowel disease in childhood, but because questions remain regarding its long-term safety, its use should be reserved for children with refractory disease or severe and unacceptable side effects of corticosteroids.
Topics: Administration, Oral; Adolescent; Adrenal Cortex Hormones; Azathioprine; Child; Child, Preschool; Colitis, Ulcerative; Crohn Disease; Drug Evaluation; Female; Follow-Up Studies; Humans; Inflammatory Bowel Diseases; Male; Time Factors
PubMed: 2231216
DOI: 10.1016/s0022-3476(05)83349-9 -
British Journal of Hospital Medicine... Oct 2013
Review
Topics: Azathioprine; Drug-Related Side Effects and Adverse Reactions; Humans
PubMed: 24273766
DOI: No ID Found -
Zeitschrift Fur Gastroenterologie May 2017Azathioprine is recommended as first-line immunosuppressant in patients with steroid-dependent inflammatory bowel diseases (IBDs). However, data on steroid withdrawal...
Azathioprine is recommended as first-line immunosuppressant in patients with steroid-dependent inflammatory bowel diseases (IBDs). However, data on steroid withdrawal after induction therapy in IBD patients are sparse. In this post-hoc analysis of a prospective multicenter study, we analyzed the proportion and clinical characteristics of 324 azathioprine-tolerant patients as to whether they could terminate the glucocorticoid therapy after initiation of treatment with azathioprine. Systemic steroid therapy was required in 190 patients (58.6 %) at baseline and in 40 patients (12.3 %) at the end of the follow-up period (p < 0.001). The median daily dose was 30 mg at baseline and 10 mg at follow-up. At baseline, only 122 patients (37.2 %) were advised to take at least the lowest recommended dose of 2 mg/kg per day. At follow-up, 221 patients (68.2 %) were prescribed at least the recommended maintenance dosage. The majority of patients with thiopurine-naïve IBDs that needed systemic steroids at baseline were able to discontinue steroids after 3 - 6 months of azathioprine therapy. These data support the continued high value of azathioprine in the immunosuppressive therapy of IBD.
Topics: Azathioprine; Glucocorticoids; Humans; Immunosuppressive Agents; Inflammatory Bowel Diseases; Prospective Studies
PubMed: 28499322
DOI: 10.1055/s-0043-106310 -
Digestive Diseases and Sciences Apr 1981
Clinical Trial
Topics: Azathioprine; Clinical Trials as Topic; Crohn Disease; Double-Blind Method; Humans; Prednisone; Random Allocation; Sulfasalazine
PubMed: 6113105
DOI: 10.1007/BF01308382 -
Digestive Diseases and Sciences Apr 1981
Clinical Trial
Topics: Adjuvants, Pharmaceutic; Azathioprine; Clinical Trials as Topic; Crohn Disease; Double-Blind Method; Humans; Mercaptopurine
PubMed: 7016483
DOI: 10.1007/BF01308381 -
Journal of Medicinal Chemistry Jul 1989Azathioprine [Imuran; 6-[(1-methyl-4-nitro-1H-imidazol-5-yl)thio]-1H-purine] is a widely used immunosuppressive and antiarthritic drug. For the sake of comparison, the...
Azathioprine [Imuran; 6-[(1-methyl-4-nitro-1H-imidazol-5-yl)thio]-1H-purine] is a widely used immunosuppressive and antiarthritic drug. For the sake of comparison, the riboside, the 2'-deoxyriboside, and the arabinoside of azathioprine and its 2-amino congener, thiamiprine, were prepared by an enzymatic method. In vitro, the cytotoxicities of these aglycons and their nucleosides were similar (ED50 = 0.8-2 microM), except for the arabinosides, which were nontoxic (ED50 greater than 100 microM). In vivo, their activities were compared in the rat adjuvant arthritis model. The ribosides and 2'-deoxyribosides were less potent than their corresponding aglycons. The safety indexes of these nucleosides were comparable to those of the corresponding aglycons except for the 2'-deoxyriboside of azathioprine, which had an appreciably lower safety index than did azathioprine. Both arabinosides were inactive and nontoxic. All of the aglycons tested (6-mercaptopurine, azathioprine, 6-thioguanine, and thiamiprine) were of similar potency. However, azathioprine had a more favorable therapeutic index than did 6-mercaptopurine. Similarly, thiamiprine was safer than was 6-thioguanine. In this model, the S-(1-methyl-4-nitro-1H-imidazol-5-yl) moiety imparted greater safety to these thiopurines by decreasing toxicity but not affecting potency.
Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Experimental; Azathioprine; Cell Survival; Cells, Cultured; Chemical Phenomena; Chemistry; Disease Models, Animal; Female; Humans; Nucleosides; Rats
PubMed: 2738881
DOI: 10.1021/jm00127a013 -
Zeitschrift Fur Hautkrankheiten Dec 1984The clinical signs and symptoms of a patient induced us to consider critically the so far known side effects of azathioprine. The literature concerning 643 patients...
The clinical signs and symptoms of a patient induced us to consider critically the so far known side effects of azathioprine. The literature concerning 643 patients treated with azathioprine reports on reactions as changes in blood count, gastro-intestinal complaints, intrahepatic cholestasis, acute pancreatitis, and leukemia. Irreversible side effects occurred in four cases.
Topics: Aged; Azathioprine; Gastrectomy; Hepatic Encephalopathy; Humans; Jaundice; Male; Methylprednisolone; Pemphigoid, Bullous; Stomach Ulcer
PubMed: 6523959
DOI: No ID Found -
Lancet (London, England) Nov 1970
Clinical Trial Randomized Controlled Trial
Topics: Azathioprine; Crohn Disease; Humans; Time Factors
PubMed: 4097954
DOI: 10.1016/s0140-6736(70)92347-0 -
Gastroenterologie Clinique Et Biologique 1991Three cases of nodular regenerative hyperplasia of the liver associated with azathioprine therapy are reported. The indication of azathioprine differed in each of the 3... (Review)
Review
Three cases of nodular regenerative hyperplasia of the liver associated with azathioprine therapy are reported. The indication of azathioprine differed in each of the 3 cases including kidney transplantation, graft-versus-host disease following bone marrow transplantation, and suspicion of bowel inflammatory disease, respectively. In all three patients, nodular regenerative hyperplasia was discovered after a prolonged administration of azathioprine (24 to 40 months), with a cumulative dose of 52 to 120 g. Under light microscopy, vascular lesions were associated with nodular regenerative hyperplasia in the 3 cases and consisted of sinusoidal dilatation (2 cases), perisinusoidal fibrosis (2 cases), and peliosis (1 case). In two patients, nodular regenerative hyperplasia was responsible for severe portal hypertension which was treated by portacaval shunt. These findings are strongly suggestive of a role of azathioprine in the occurrence of nodular regenerative hyperplasia. The mechanism of azathioprine-induced nodular regenerative hyperplasia could be related to sinusoidal lesions caused by azathioprine and responsible for liver hypoperfusion, with regenerative hyperplasia in the areas remaining normally perfused. Patients receiving long-term therapy with azathioprine should be followed-up regularly and liver biopsy should be performed when clinical or biochemical liver abnormalities are observed.
Topics: Adult; Azathioprine; Graft vs Host Disease; Humans; Hyperplasia; Hypertension, Portal; Immunosuppression Therapy; Kidney Transplantation; Liver; Male; Middle Aged; Rectal Diseases
PubMed: 1783253
DOI: No ID Found