BACKGROUND AND AIMS: Azathioprine (AZA) is an established treatment for ulcerative colitis (UC).However, controversy exists regarding its efficacy in inducing and maintaining clinical remission, and long-term data are lacking. We studied the effectiveness of AZA in a large cohort of UC patients treated in a single center. METHODS:All UC patients treated withAZA were identified from a prospective electronic database. We assessed response to therapy at 4 months and sustained clinical benefit at the last point of follow-up. We also examined predictors of response and sustained clinical benefit, as well as outcomes in those treated with AZA for >5 years. RESULTS: The study included 255 patients. At 4 months, 207 (81.2%) of 255 patients were still on AZA and 163 (63.9%) had responded to therapy. At the last point of follow-up 164 (64.3%) patients were still receiving AZA, of whom 154 (60.4%) achieved sustained clinical benefit. This effect was durable among 71 patients who received AZA for >5 years, with 61 (85.9%) considered to have achieved sustained clinical benefit. Twenty-six patients required admission to hospital for an exacerbation during AZA treatment, 20 patients ultimately required biologic therapy, and 21 underwent colectomy. Only two (2.8%) of 71 patients receiving AZA for >5 years needed to escalate to a biologic therapy, and only one (1.4%) required a colectomy. CONCLUSIONS:AZA is a safe and effective therapy in UC patients who fail 5-aminosalisylates in both the short and long term. Escalation to a biologic therapy or colectomy was unlikely among patients who were able to continue AZA therapy beyond 5 years.
RCT Entities:
BACKGROUND AND AIMS: Azathioprine (AZA) is an established treatment for ulcerative colitis (UC).However, controversy exists regarding its efficacy in inducing and maintaining clinical remission, and long-term data are lacking. We studied the effectiveness of AZA in a large cohort of UC patients treated in a single center. METHODS: All UC patients treated with AZA were identified from a prospective electronic database. We assessed response to therapy at 4 months and sustained clinical benefit at the last point of follow-up. We also examined predictors of response and sustained clinical benefit, as well as outcomes in those treated with AZA for >5 years. RESULTS: The study included 255 patients. At 4 months, 207 (81.2%) of 255 patients were still on AZA and 163 (63.9%) had responded to therapy. At the last point of follow-up 164 (64.3%) patients were still receiving AZA, of whom 154 (60.4%) achieved sustained clinical benefit. This effect was durable among 71 patients who received AZA for >5 years, with 61 (85.9%) considered to have achieved sustained clinical benefit. Twenty-six patients required admission to hospital for an exacerbation during AZA treatment, 20 patients ultimately required biologic therapy, and 21 underwent colectomy. Only two (2.8%) of 71 patients receiving AZA for >5 years needed to escalate to a biologic therapy, and only one (1.4%) required a colectomy. CONCLUSIONS:AZA is a safe and effective therapy in UC patients who fail 5-aminosalisylates in both the short and long term. Escalation to a biologic therapy or colectomy was unlikely among patients who were able to continue AZA therapy beyond 5 years.
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: Elsa L S A van Liere; Ahmed B Bayoumy; Chris J J Mulder; Ben Warner; Bu Hayee; Bilal A Mateen; Jonathan D Nolan; Nanne K H de Boer; Simon H C Anderson; Azhar R Ansari Journal: Dig Dis Sci Date: 2021-11-02 Impact factor: 3.487
Authors: Evangelos Stournaras; Wendi Qian; Tim Raine; Miles Parkes; Apostolos Pappas; You Yi Hong; Rasha Shawky Journal: Gut Date: 2020-10-01 Impact factor: 23.059