Digestive Diseases and Sciences

, Volume 51, Issue 9, pp 1516–1524

Long-Term Effectiveness of Azathioprine in IBD Beyond 4 Years: A European Multicenter Study in 1176 Patients

Authors

  • Martin H. Holtmann
    • First Department of MedicineJohannes Gutenberg University
  • Frank Krummenauer
    • Department for Medical Biometrics, Epidemiology and InformaticsJohannes Gutenberg University
  • Christina Claas
    • First Department of MedicineJohannes Gutenberg University
  • Kristina Kremeyer
    • First Department of MedicineJohannes Gutenberg University
  • Dirk Lorenz
    • First Department of MedicineJohannes Gutenberg University
  • Olivia Rainer
    • First Department of MedicineJohannes Gutenberg University
  • Iris Vogel
    • First Department of MedicineJohannes Gutenberg University
  • Ulrich Böcker
    • Department of Medicine IIUniversity Hospital
  • Stephan Böhm
    • Department of GastroenterologyUniversity Hospital, Philipps University
  • Carsten Büning
    • Department of Gastroenterology, ChariteVirchow Hospital, University of Berlin
  • Rainer Duchmann
    • Medicle Clinic IUniversity of Medicine Berlin-Charite, Campus Benjamin Franklin Berlin
  • Guido Gerken
    • Department of GastroenterologyUniversity Hospital
  • Hans Herfarth
    • Department of Internal Medicine IUniversity Hospital
  • Norbert Lügering
    • Department of GastroenterologyUniversity Hospital
  • Wolfgang Kruis
    • Department of Internal MedicineKalk-Hospital
  • Max Reinshagen
    • Department of GastroenterologyUniversity Hospital
  • Jan Schmidt
    • Department of SurgeryUniversity Hospital
  • Andreas Stallmach
    • Department of GastroenterologyUniversity Hospital
  • Jürgen Stein
    • Department of GastroenterologyUniversity Frankfurt
  • Andreas Sturm
    • Department of GastroenterologyVirchow Hospital, University of Berlin
  • Peter R. Galle
    • First Department of MedicineJohannes Gutenberg University
  • Daan W. Hommes
    • Department of GastroenterologyAcademic Medical Center
  • Geert D’Haens
    • Department of GastroenterologyUniversity Hospital
  • Paul Rutgeerts
    • Department of GastroenterologyUniversity Hospital
    • First Department of MedicineJohannes Gutenberg University
    • I. Medical ClinicUniversity of Mainz
Original Paper

DOI: 10.1007/s10620-005-9037-5

Cite this article as:
Holtmann, M.H., Krummenauer, F., Claas, C. et al. Dig Dis Sci (2006) 51: 1516. doi:10.1007/s10620-005-9037-5

Abstract

In Crohn’s disease the optimal duration of azathioprine treatment is still controversial and for ulcerative colitis only limited data are available to support its efficacy. Charts of 1176 patients with IBD from 16 European centers were analyzed. Flare incidences and steroid dosages were assessed for the time before and during treatment and after discontinuation. Within the first 4 years, azathioprine suppressed flare incidence and steroid consumption in both diseases (P < 0.001). While in CD discontinuation after 3–4 years did not lead to reactivation, this was the case in UC. However, continuation beyond 4 years further improved clinical activity in CD and steroid requirement in both diseases (P < 0.001). Discontinuation of azathioprine may thus be considered after 3–4 years in CD patients in complete remission without steroid requirement. In all other CD patients and for UC patients in general, continuation seems beneficial. These results support a novel differential algorithm for long-term azathioprine therapy in IBD.

Keywords

AzathioprineCrohn’s diseaseUlcerative colitisLong-term immunosuppression

Copyright information

© Springer Science+Business Media, Inc. 2006