BACKGROUND/AIMS: Azathioprine (AZA) and 6-mercaptopurine (6-MP) have been widely used in patients with ulcerative colitis (UC) and Crohn's disease (CD). However, some patients cannot tolerate standard doses (2-2.5 mg/kg for AZA or 1-1.5 mg/kg for 6-MP) due to side effects such as leukopenialneutropenia. The aim of this study was to evaluate the efficacy of low dose AZA/6-MP compared to the standard dose. METHODOLOGY: From 1995 to 2005, 122 patients with UC or CD treated with AZA/6-MP at Samsung Medical Center in Korea were enrolled. We divided these patients into 2 groups (standard dose group versus low dose group) according to the maintenance dose. RESULTS: Among the 122 patients, 17 received the standard dose and 105 received a low dose. The mean maintenance doses were 2.25 mg/kg for the standard dose group and 1.35mg/kg for the low dose group. The clinical outcomes of remission induction, maintenance of remission and relapse rate showed no significant difference in comparisons between these two groups. CONCLUSION: Low dose AZA/6-MP was as effective as the standard dose for remission induction and maintenance of remission in patients with UC and CD. For patients that develop leukopenia/neutropenia during dose escalation, maintenance therapy with low dose AZA/6-MP should be considered.
BACKGROUND/AIMS: Azathioprine (AZA) and 6-mercaptopurine (6-MP) have been widely used in patients with ulcerative colitis (UC) and Crohn's disease (CD). However, some patients cannot tolerate standard doses (2-2.5 mg/kg for AZA or 1-1.5 mg/kg for 6-MP) due to side effects such as leukopenialneutropenia. The aim of this study was to evaluate the efficacy of low dose AZA/6-MP compared to the standard dose. METHODOLOGY: From 1995 to 2005, 122 patients with UC or CD treated with AZA/6-MP at Samsung Medical Center in Korea were enrolled. We divided these patients into 2 groups (standard dose group versus low dose group) according to the maintenance dose. RESULTS: Among the 122 patients, 17 received the standard dose and 105 received a low dose. The mean maintenance doses were 2.25 mg/kg for the standard dose group and 1.35mg/kg for the low dose group. The clinical outcomes of remission induction, maintenance of remission and relapse rate showed no significant difference in comparisons between these two groups. CONCLUSION: Low dose AZA/6-MP was as effective as the standard dose for remission induction and maintenance of remission in patients with UC and CD. For patients that develop leukopenia/neutropenia during dose escalation, maintenance therapy with low dose AZA/6-MP should be considered.
Authors: Hai Yun Shi; Francis K L Chan; Wai Keung Leung; Michael K K Li; Chi Man Leung; Shun Fung Sze; Jessica Y L Ching; Fu Hang Lo; Steven W C Tsang; Edwin H S Shan; Lai Yee Mak; Belsy C Y Lam; Aric J Hui; Wai Hung Chow; Marc T L Wong; Ivan F N Hung; Yee Tak Hui; Yiu Kay Chan; Kam Hon Chan; Ching Kong Loo; Carmen K M Ng; Wai Cheung Lao; Marcus Harbord; Justin C Y Wu; Joseph J Y Sung; Siew C Ng Journal: Therap Adv Gastroenterol Date: 2016-04-19 Impact factor: 4.409
Authors: Morris Gordon; Ciaran Grafton-Clarke; Anthony Akobeng; John Macdonald; Nilesh Chande; Stephen Hanauer; Ian Arnott Journal: Frontline Gastroenterol Date: 2020-06-11