Gastroenterology

Gastroenterology

Volume 101, Issue 1, July 1991, Pages 39-46
Gastroenterology

Use of azathioprine or 6-mercaptopurine in the treatment of Crohn's disease

https://doi.org/10.1016/0016-5085(91)90457-VGet rights and content
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Abstract

The efficacy and safety of therapy with azathioprine/6-mercaptopurine was studied in 78 patients with Crohn's disease. Mean duration of therapy was 1.6 years; 52 patients were treated ≥ 6 months. All patients were also on other antiinflammatory medications. Evaluations included self-assessment and physician's assessment of well-being, functional capacity, general clinical response, clinical activities indices (National Foundation for Ileitis and Colitis/International Organization for the Study of Inflammatory Bowel Disease and Harvey-Bradshaw), and achievement of specific therapeutic goals. General clinical condition improved in 70% of the patients. Median response time was 3 months. The average Harvey-Bradshaw score decreased 37% with therapy, and a decrease of ≥ 30% occurred in 66% of the subjects. An overall 72% achievement rate for specified therapeutic goals included controlling refractory disease, 73%; corticosteroid “sparing,” 76%; and lessening fistulization, 63%. Nine patients got worse despite therapy. Adverse effects requiring discontinuation of therapy occurred in 10%, whereas dosages were briefly lowered for mild side effects in another 10%. This study demonstrates the effectiveness and safety of azathioprine/6-mercaptopurine in the majority of selected patients with chronic, unremitting, or steroid-requiring Crohn's disease.

Abbreviations

6-MP
6-mercaptopurine
AZA
azathioprine
ESR
erythrocyte sedimentation rate
IOIBD
International Organization for the Study of Inflammatory Bowel Disease
NCCDS
National Cooperative Crohn's Disease Study
NFIC
National Foundation for Ileitis and Colitis (Crohn's Colitis Foundation of America)

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This work was supported by Harvey M. and Lyn P. Meyerhoff Digestive Disease/Inflammatory Bowel Disease Center, Pat and John Rosenwald Philanthropic Fund, and Cynthia and Peter Rosenwald Fund.