Efficacy and safety of azathioprine therapy in Turkish patients with inflammatory bowel disease: A retrospective long term follow up study

Abstract

Objective: Effectivity and safety of azathioprine in the treatment of inflammatory bowel disease have been proved and cited in many articles. Objective of this study is to evaluate the efficacy and side effects of azathioprine particularly in the long term treatment and postsurgical prophylaxis of Crohn's disease in Turkish patients with inflammatory bowel disease. Material and Methods: Patients treated with azathioprine were enrolled in this study and the efficacy of azathioprine was assessed with Truelove-Witts and Crohn's Disease Activity Indexes, retrospectively. Results: A total of 122 patients treated with azathioprine with a median duration of 24 months, including 109 patients with Crohn's disease and 13 with ulcerative colitis, were evaluated. Response (complete or partial remission) was observed in 106 (98+8, 87%) of 122 patients. The median duration of remission during the treatment was 21 months. Adverse effects were observed in 16% (19/122) of our patients and myelotoxicity was the most frequent adverse effect seen in 6.6% (8/122) of the patients. Drug discontinuation rate due to side effects was 9.8%. Overall response (complete and partial remission)was seen in 38 (36+2, 90.5%) out of 42 patients that had been taking azathioprin for more than four years with a median period of 60 months. The median of remission duration in those patients that had similar side effects was 53 months. Clinical recurrence was seen in six of 31 patients treated with azathioprine for post-surgical prophylaxis in a median follow-up of 42 months. Conclusion: Our study re-affirmed the safety and the effectiveness of azathioprine in the treatment of inflammatory bowel disease, especially for post-surgical prophylaxis and the long term treatment. © 2011 by Türkiye Klinikleri.