Low-dose azathioprine is effective in maintaining remission in steroid-dependent ulcerative colitis: results from a territory-wide Chinese population-based IBD registry

Abstract

In the Chinese population, low-dose AZA is effective for maintaining remission in steroid-dependent UC patients. Standard-dose AZA was associated with more than threefold increased risk of leukopenia.

Low 6‐thioguanine nucleotide level: Effective in maintaining remission in Chinese patients with Crohn's disease

“…This could exclude many patients experiencing adverse events during AZA treatment. In fact, the rate of adverse events in the screening of 634 patients was comparable with previous studies (data now shown) …”

“…The cut‐off of 6‐TGN level was 180 pmol/8 × 10 8 RBC, which was lower than that reported in Caucasians (235 pmol/8 × 10 8 RBC). Different thiopurine metabolic features between Asians and Caucasians may account for such differences …”

“…In the present study, we evaluated the clinical use of AZA for optimizing therapeutic response and found that a dose of ≥ 1.50 mg/kg/day may be the appropriate dose cut‐off for CD patients, which was consistent with the aforementioned studies. The high concomitant use of 5‐ASA may partly explain the satisfactory efficacy of low‐dose AZA in Asians with CD …”

“…Adverse effects associated with AZA included gastric intolerance, flu‐like symptoms, pancreatitis, hepatitis, rash, myelotoxicity, and others including infection and nonspecific side effects during treatment but requiring withdrawal or decreasing the dose of AZA . Leukopenia was defined as a white blood cell count less than 3 × 10 9 /L …”

Letter: thiopurines ‐ is less really more? Authors’ reply

“…sufficient to obtain a favourable and sustained pharmacokinetics of IFX as previously described by Yarur et al 5 In this latter work, 6 are improved by lowering the dose of AZA, which is crucial to achieve adherence to treatment.…”