BACKGROUND: An interaction between azathioprine and 5-aminosalicylates may exist, but the mechanism remains unclear. OBJECTIVES: To investigate the occurrence of adverse events and efficacy of azathioprine with or without mesalazine. METHOD: Retrospective study of 199 patients. In all, 95 patients received azathioprine alone (monotherapy); 104 received combination of 5-aminosalicylates and azathioprine (dual therapy). Data were recorded on adverse events, azathioprine dose and thiopurine methyl transferase (TPMT) level. In 85 of the patients, relapse rate was compared in the two groups. RESULTS: Adverse events were more common in dual therapy group, 50/104, than in monotherapy group, 29/95; chi=6.4, P=0.05. Most patients had normal TPMT activity. No relationship between TPMT activity and adverse events was observed. A total of 105 patients took (>or=2 mg/kg) azathioprine; adverse events occurred in 26% compared with 54% taking less than 2 mg/kg (chi=15.8, P<0.0001). Discontinuation of azathioprine owing to adverse events was found to be higher in dual therapy group, 26/50, than in monotherapy group, 7/29 (chi=5.0, P<0.01). Relapse rate was higher in the dual therapy group (29/49) than with monotherapy (12/36) (chi=5.5, P<0.02). CONCLUSION: Adverse events are more common in patients taking dual therapy than azathioprine monotherapy. Adverse events are unrelated to dose of azathioprine. Patients receiving dual therapy are more likely to relapse than patients receiving monotherapy.
BACKGROUND: An interaction between azathioprine and 5-aminosalicylates may exist, but the mechanism remains unclear. OBJECTIVES: To investigate the occurrence of adverse events and efficacy of azathioprine with or without mesalazine. METHOD: Retrospective study of 199 patients. In all, 95 patients received azathioprine alone (monotherapy); 104 received combination of 5-aminosalicylates and azathioprine (dual therapy). Data were recorded on adverse events, azathioprine dose and thiopurine methyl transferase (TPMT) level. In 85 of the patients, relapse rate was compared in the two groups. RESULTS: Adverse events were more common in dual therapy group, 50/104, than in monotherapy group, 29/95; chi=6.4, P=0.05. Most patients had normal TPMT activity. No relationship between TPMT activity and adverse events was observed. A total of 105 patients took (>or=2 mg/kg) azathioprine; adverse events occurred in 26% compared with 54% taking less than 2 mg/kg (chi=15.8, P<0.0001). Discontinuation of azathioprine owing to adverse events was found to be higher in dual therapy group, 26/50, than in monotherapy group, 7/29 (chi=5.0, P<0.01). Relapse rate was higher in the dual therapy group (29/49) than with monotherapy (12/36) (chi=5.5, P<0.02). CONCLUSION: Adverse events are more common in patients taking dual therapy than azathioprine monotherapy. Adverse events are unrelated to dose of azathioprine. Patients receiving dual therapy are more likely to relapse than patients receiving monotherapy.
Authors: Gabriele Stocco; Eva Cuzzoni; Sara De Iudicibus; Diego Favretto; Noelia Malusà; Stefano Martelossi; Elena Pozzi; Paolo Lionetti; Alessandro Ventura; Giuliana Decorti Journal: World J Gastroenterol Date: 2015-03-28 Impact factor: 5.742
Authors: Ryan C Ungaro; Berkeley N Limketkai; Camilla Bjørn Jensen; Clara Yzet; Kristine H Allin; Manasi Agrawal; Thomas Ullman; Johan Burisch; Tine Jess; Jean-Frederic Colombel Journal: Clin Gastroenterol Hepatol Date: 2019-08-13 Impact factor: 11.382
Authors: Chang Hwan Choi; Won Moon; You Sun Kim; Eun Soo Kim; Bo-In Lee; Yunho Jung; Yong Sik Yoon; Heeyoung Lee; Dong Il Park; Dong Soo Han Journal: Intest Res Date: 2017-01-31