Efficacy and Safety of Azathioprine Therapy in Turkish Patients with Inflammatory Bowel Disease: A Retrospective Long Term Follow Up Study

Abstract

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : Ef fec ti vity and sa fety of azat hi op ri ne in the tre at ment of inf lam ma tory bowel di se a se ha ve be en pro ved and ci ted in many ar tic les. Ob jec ti ve of this study is to eva lu a te the effi cacy and si de ef fects of azat hi op ri ne par ti cu larly in the long term tre at ment and post sur gi cal proph yla xis of Crohn's di se a se in Tur kish pa ti ents with inf lam ma tory bo wel di se a se. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : Pa ti ents tre a ted with azat hi op ri ne we re en rol led in this study and the ef ficacy of azat hiop ri ne was as ses sed with Tru e lo ve-Witts and Crohn's Di se a se Ac ti vity In de xes, retrospectively. R Re e --s su ul lt ts s: : A total of 122 pa ti ents tre a ted with azat hi op ri ne with a me di an du ra ti on of 24 months, inc lu ding 109 pa ti ents with Crohn's di se a se and 13 with ul ce ra ti ve co li tis, we re eva lu a ted. Res ponse (comp le te or par ti al re mis si on) was ob ser ved in 106 (98+8, 87%) of 122 pa ti ents. The me di an dura ti on of re mis si on du ring the tre at ment was 21 months. Ad ver se ef fects we re ob ser ved in 16% (19/122) of our pa ti ents and mye lo to xi city was the most fre qu ent ad ver se ef fect seen in 6.6% (8/122) of the patients. Drug dis con ti nu a ti on ra te du e to si de ef fects was 9.8%. Ove rall res pon se (comp le te and par ti al re mis si on)was seen in 38 (36+2, 90.5%) out of 42 pa ti ents that had be en ta king azat hi oprin for mo re than fo ur ye ars with a me di an period of 60 months. The me di an of re mis si on du ra ti on in tho se pa ti ents that had si mi lar si de ef fects was 53 months. Cli ni cal re cur ren ce was se en in six of 31 pa ti ents tre a ted with azat hi op ri ne for post-sur gi cal proph yla xis in a me di an fol low-up of 42 months. C Co on nc c l lu u s si i o on n: : Our study re-af fir med the sa fety and the ef fec ti ve ness of azat hi op ri ne in the treat ment of inf lam ma tory bo wel di se a se, es pe ci ally for post-sur gi cal proph yla xis and the long term tre at ment. K Ke ey y W Wo or rd ds s: : Inf lam ma tory bo wel di se a ses; azat hi op ri ne; ad ver se ef fects Ö ÖZ ZE ET T A Am ma aç ç: : Azatioprinin inf la ma tu ar bağırsak has ta lı ğı (İBH) nın te da vi sin de ki et kin li ği ve gü -ve ni lir li li ği hak kın da der len miş ka nıt lar bu lun mak ta dır. Ça lış ma mı zın ama cı, İBH olan Türk hasta lar da özel lik le de Crohn's has ta lı ğı nın uzun dö nem te da vi si ve cer ra hi son ra sı pro fi lak si si üze ri ne vur gu yap mak üze re ila cın et kin li ği ve yan et ki du ru mu nu or ta ya koy mak tır. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Azatioprin te da vi si al mış top lam 122 has ta ge ri ye dö nük de ğer len di ril mek üze re ça -lış ma ya alın mış tır. İla cın et kin li ği ni be lir le me de Tru e lo ve-Witts ve Crohn Has ta lı ğı Ak ti vi te İn-deks le ri kul la nıl mış tır. B Bu ul l g gu u l la ar r: : Top lam 109 Crohn ve 13 ül ...

Maintenance therapy for Crohn’s disease

“…However, a multicenter, randomized, double-blind, noninferiority withdrawal trial did not confirm these results and it was suggested that AZA maintenance therapy should be continued beyond 3.5 years [125]. In the two other studies including patients maintained on prolonged remission for more than 5 years with AZA, one-third to almost one-half of all patients developed a relapse at 2 years after AZA interruption [126,127]. Unfortunately, AZA withdrawal studies have different designs, heterogeneous patient populations, and different inclusion/ exclusion criteria.…”

Role of Inflammatory Markers as Predictors of Clinical Activity and Endoscopic Severity in Crohn’s Disease

“…The disease has a dynamic behaviour and disease activity often shows fluctuations (1,2). Approximately 13% of CD patients have chronically active disease, 73% have a chronic intermittent course, while only 10% remain in prolonged remission over many years (2).…”