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Der Internist Aug 1993
Review
Topics: Autoimmune Diseases; Azathioprine; Drug Interactions; Graft Rejection; Humans
PubMed: 8375993
DOI: No ID Found -
Archives of Dermatology Apr 1991Azathioprine sodium has been reported to be effective therapy for chronic cutaneous lupus erythematosus (LE) but rarely for chronic cutaneous leukocytoclastic vasculitis... (Clinical Trial)
Clinical Trial
Azathioprine. An effective, corticosteroid-sparing therapy for patients with recalcitrant cutaneous lupus erythematosus or with recalcitrant cutaneous leukocytoclastic vasculitis.
Azathioprine sodium has been reported to be effective therapy for chronic cutaneous lupus erythematosus (LE) but rarely for chronic cutaneous leukocytoclastic vasculitis (LV). We used azathioprine in the treatment of six patients with cutaneous LE, four of whom had subacute cutaneous (nonscarring) LE and two of whom had chronic cutaneous (scarring, discoid) LE, and six patients with chronic cutaneous LV. The conditions of all patients had been resistant to conventional therapy, and they required long-term oral corticosteroid therapy for control of their disease. Two of the patients with LE had prominent palmar and/or plantar involvement. Three patients with LE had an excellent response to azathioprine, with near complete clearing of the skin lesions, allowing a decrease in prednisone dosage. One patient with LE initially demonstrated significant improvement, but azathioprine therapy had to be discontinued because of pancreatitis. The treatment failed in two patients with LE; one had nausea and the other repeatedly developed a drug-induced fever. Five of the six patients with LV had improved conditions, with complete control of the disease occurring in two patients and partial control in three patients. Azathioprine is effective for some patients with cutaneous LE and chronic cutaneous LV, but it should be reserved for patients with severe disease in whom more conventional treatment fails.
Topics: Adult; Azathioprine; Female; Humans; Lupus Erythematosus, Cutaneous; Male; Middle Aged; Vasculitis, Leukocytoclastic, Cutaneous
PubMed: 2006876
DOI: 10.1001/archderm.127.4.515 -
The Journal of Organic Chemistry Jan 2023In this Note, the successful structural assignment of a proton-deficient nucleic acid analogue using the H-C long-range heteronuclear single quantum multiple bond...
In this Note, the successful structural assignment of a proton-deficient nucleic acid analogue using the H-C long-range heteronuclear single quantum multiple bond correlation (LR-HSQMBC) technique is described. LR-HSQMBC is a 2D NMR technique for the sensitive detection of weak C-H spin couplings. The immunosuppressant drug, azathioprine, served as the target compound. The LR-HSQMBC measurements revealed the existence of covalent bonds between the purine and imidazole rings based on observations of and with good sensitivity.
Topics: Protons; Azathioprine; Magnetic Resonance Spectroscopy; Magnetic Resonance Imaging; Nucleic Acids
PubMed: 36563180
DOI: 10.1021/acs.joc.2c01785 -
Journal of the European Academy of... Dec 2019
Topics: Alopecia Areata; Azathioprine; Drug Therapy, Combination; Humans; Methotrexate
PubMed: 31374131
DOI: 10.1111/jdv.15834 -
Die Medizinische Welt Jul 1976
Topics: Adult; Azathioprine; Cholestasis; Female; Granulomatosis with Polyangiitis; Hepatitis; Humans; Male
PubMed: 957953
DOI: No ID Found -
Archives of Dermatology Nov 2006To investigate the safety and efficacy of oral methylprednisolone combined with azathioprine sodium or mycophenolate mofetil for the treatment of pemphigus. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate the safety and efficacy of oral methylprednisolone combined with azathioprine sodium or mycophenolate mofetil for the treatment of pemphigus.
DESIGN
A prospective, multicenter, randomized, nonblinded clinical trial to compare 2 parallel groups of patients with pemphigus (pemphigus vulgaris and pemphigus foliaceus) treated with oral methylprednisolone plus azathioprine or oral methylprednisolone plus mycophenolate mofetil. Settings Thirteen departments of dermatology in Germany. Patients We included patients with pemphigus vulgaris (n = 33) or pemphigus foliaceus (n = 7) evidenced by clinical lesions suggestive of pemphigus, intraepidermal blistering on histological analysis of skin biopsy specimens, intercellular deposition of IgG within the epidermis, and immunoblot analysis findings for antidesmoglein 3 and/or antidesmoglein 1 autoantibodies.
MAIN OUTCOME MEASURES
The cumulative total methylprednisolone doses and rate of remission. Secondary outcome measures were safety profiles and duration of remission.
RESULTS
In 13 (72%) of 18 patients with pemphigus receiving oral methylprednisolone and azathioprine, complete remission was achieved after a mean +/- SD of 74 +/- 127 days compared with 20 (95%) of 21 patients receiving oral methylprednisolone and mycophenolate mofetil in whom complete remission occurred after a mean +/- SD of 91 +/- 113 days. The total median cumulative methylprednisolone dose used was 8916 mg (SD, +/-29 844 mg) in the azathioprine group compared with 9334 mg (SD, +/-13 280 mg) in the mycophenolate group. In 6 (33%) of 18 patients treated with azathioprine, grade 3 or 4 adverse effects were documented in contrast to 4 (19%) of 21 patients who received mycophenolate mofetil. Conclusion Mycophenolate mofetil and azathioprine demonstrate similar efficacy, corticosteroid-sparing effects, and safety profiles as adjuvants during treatment of pemphigus vulgaris and pemphigus foliaceus.
Topics: Administration, Oral; Anti-Inflammatory Agents; Azathioprine; Disease-Free Survival; Drug Therapy, Combination; Female; Germany; Humans; IMP Dehydrogenase; Immunosuppressive Agents; Male; Methylprednisolone; Middle Aged; Mycophenolic Acid; Pemphigus; Prospective Studies; Severity of Illness Index; Treatment Outcome
PubMed: 17116835
DOI: 10.1001/archderm.142.11.1447 -
Canadian Medical Association Journal Dec 1973
Topics: Adult; Arthritis; Azathioprine; Fever; Humans; Liver Cirrhosis; Male
PubMed: 4759485
DOI: No ID Found -
The American Journal of Medicine May 1988Fever in a transplant recipient is an important sign of graft rejection or infection. Rarely, fever may result from an immunosuppressive agent used to prevent graft... (Review)
Review
Fever in a transplant recipient is an important sign of graft rejection or infection. Rarely, fever may result from an immunosuppressive agent used to prevent graft rejection. A case of fever, rigors, arthralgias, and myalgias is reported in a cardiac transplant recipient in whom azathioprine therapy was recently begun. These findings resolved on discontinuation of the azathioprine, recurred on rechallenge, and were most consistent with a hypersensitivity reaction. The clinical spectrum of reported azathioprine hypersensitivity reactions is reviewed.
Topics: Adult; Azathioprine; Drug Hypersensitivity; Graft Rejection; Heart Transplantation; Humans; Male
PubMed: 3284343
DOI: 10.1016/0002-9343(88)90079-4 -
BMJ (Clinical Research Ed.) Jul 1992To determine whether azathioprine can prevent relapse in ulcerative colitis. (Clinical Trial)
Clinical Trial Randomized Controlled Trial
OBJECTIVE
To determine whether azathioprine can prevent relapse in ulcerative colitis.
DESIGN
One year placebo controlled double blind trial of withdrawal or continuation of azathioprine.
SETTING
Outpatient clinics of five hospitals.
SUBJECTS
79 patients with ulcerative colitis who had been taking azathioprine for six months or more. Patients in full remission for two months or more (67), and patients with chronic low grade or corticosteroid dependent disease (12) were randomised separately. 33 patients in remission received azathioprine and 34 placebo; five patients with chronic stable disease received azathioprine and seven placebo.
MAIN OUTCOME MEASURE
Rate of relapse. Relapse was defined as worsening of symptoms or sigmoidoscopic appearance.
RESULTS
For the remission group the one year rate of relapse was 36% (12/33) for patients continuing azathioprine and 59% (20/34) for those taking placebo (hazard rate ratio 0.5, 95% confidence interval 0.25 to 1.0). For the subgroup of 54 patients in long term remission (greater than six months before entry to trial) benefit was still evident, with a 31% (8/26) rate of relapse with azathioprine and 61% (17/28) with placebo (p less than 0.01). For the small group of patients with chronic stable colitis (six were corticosteroid dependent and six had low grade symptoms) no benefit was found from continued azathioprine therapy. Adverse events were minimal.
CONCLUSIONS
Azathioprine maintenance treatment in ulcerative colitis is beneficial for at least two years if patients have achieved remission while taking the drug. Demonstration of the relapse preventing properties of azathioprine has implications for a large number of patients with troublesome ulcerative colitis, who may benefit from treatment with azathioprine.
Topics: Azathioprine; Chronic Disease; Colitis, Ulcerative; Double-Blind Method; Humans; Long-Term Care; Recurrence
PubMed: 1638191
DOI: 10.1136/bmj.305.6844.20 -
Gastroenterology Oct 2013A small placebo-controlled trial reported the efficacy of mercaptopurine therapy for children newly diagnosed with Crohn's disease, yet little is known about the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND & AIMS
A small placebo-controlled trial reported the efficacy of mercaptopurine therapy for children newly diagnosed with Crohn's disease, yet little is known about the efficacy of early thiopurine therapy in adults.
METHODS
We performed a prospective double-blind trial of adult patients with a recent (<8 weeks) diagnosis of Crohn's disease. Patients were randomly assigned to groups given azathioprine (2.5 mg · kg(-1) · day(-1), n = 68) or placebo (n = 63) at 31 hospitals from February 2006 to September 2009. Corticosteroids but no other concomitant medications were allowed for control of disease activity. The primary measure of efficacy was sustained corticosteroid-free remission.
RESULTS
After 76 weeks of treatment, 30 patients treated with azathioprine (44.1%) and 23 given placebo (36.5%) were in sustained corticosteroid-free remission (difference of 7.6%; 95% confidence interval, -9.2 to 24.4%; P = .48). The rates of relapse (defined as Crohn's Disease Activity Index score >175) and corticosteroid requirements were similar between groups. A post hoc analysis of relapse, defined as a Crohn's Disease Activity Index score >220, showed lower relapse rates in the azathioprine group than in the placebo group (11.8% vs 30.2%; P = .01). Serious adverse events occurred in 14 patients in the azathioprine group (20.6%) and 7 in the placebo group (11.1%) (P = .16). A larger percentage of patients in the azathioprine group had adverse events that led to study drug discontinuation (20.6%) than in the placebo group (6.35%) (P = .02).
CONCLUSIONS
In a study of adults with Crohn's disease, early azathioprine therapy was no more effective than placebo to achieve sustained corticosteroid-free remission but was more effective in preventing moderate to severe relapse in a post hoc analysis. EudraCT 2005-001186-34.
Topics: Adult; Azathioprine; Crohn Disease; Double-Blind Method; Female; Humans; Immunosuppressive Agents; Male; Prospective Studies
PubMed: 23770132
DOI: 10.1053/j.gastro.2013.06.009