The American Journal of Digestive Diseases

, Volume 20, Issue 8, pp 721–726

A controlled trial of azathioprine in Crohn's disease

  • James L. Rosenberg
  • Bernard Levin
  • Alfred J. Wall
  • Joseph B. Kirsner
Original Articles


To determine the efficacy of azathioprine in the treatment of Crohn's disease, a 26-week double-blind trial was performed. 20 patients with Crohn's disease, requiring at least 10 mg of prednisone/day over the 3 months prior to entering the study were randomized into placebo (10 patients) and azathioprine (10 patients) treatment groups. Reduction of steroids was the major criterion of success in the trial. There were 7 relapses in the placebo group (5 patients) and 2 relapses in the azathioprine group (2 patients). Complications including fistulae were not affected by the medications. The mean reduction in steroid dosage in the azathioprine group at the end of the trial (−15.5 mg) was greater than in the placebo group (−6.1 mg). These results suggest that azathioprine may permit reduction or discontinuation of steroids without the worsening of symptoms in some patients who appear to require steroids for control of their symptoms. The clinical features of this “AZA-responsive subgroup” remain to be defined.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Brooke BN, Hoffman DC, Swarbrick ET: Azathioprine for Crohn's disease. Lancet 2:612–614, 1969PubMedGoogle Scholar
  2. 2.
    Brooke BN, Javett SL, Davison OW: Further experience with azathioprine for Crohn's disease. Lancet 2:1050–1053, 1973PubMedGoogle Scholar
  3. 3.
    Patterson JF, Horton RA, Schwartz RS: Azathioprine treatment of ulcerative colitis, granulomatous colitis, and regional enteritis. Am J Dig Dis 16:327–332, 1971PubMedGoogle Scholar
  4. 4.
    Drucker WR, Jeejeebhoy KN: Azathioprine: An adjunct to surgical therapy of granulomatous enteritis. Ann Surg 172:618–625, 1970PubMedGoogle Scholar
  5. 5.
    Willoughby JMT, Parveen KJ, Beckett J, Dawson AM: Controlled trial of azathioprine in Crohn's disease. Lancet 2:944–946, 1971PubMedGoogle Scholar
  6. 6.
    Rhodes J, Bainton D, Beck P, Campbell H: Controlled trial of azathioprine in Crohn's disease. Lancet 2:1273–1276, 1971PubMedGoogle Scholar
  7. 7.
    Klein M, Binder HJ, Mitchell M, Aaronson R, Spiro H: Treatment of Crohn's disease with azathioprine: A controlled evaluation. Gastroenterology 66:916–922, 1974PubMedGoogle Scholar
  8. 8.
    Rosman M, Bertino JR: Azathioprine. Ann Intern Med 79:694–700, 1973PubMedGoogle Scholar
  9. 9.
    Rosenberg JL, Wall AJ, Settles RH, Binder HJ, Levin B, Kirsner JB. A controlled trial of azathioprine in the treatment of chronic ulcerative colitis. Gastroenterology 64:793, 1973Google Scholar
  10. 10.
    Treatment of Crohn's disease (editorial). Lancet 2:695–696, 1971Google Scholar
  11. 11.
    Walden BK, Robertson MR, Jeremy D: Skin cancer and immunosuppression. Lancet 2:1282–1283, 1971PubMedGoogle Scholar
  12. 12.
    Doll R, Kinlen L: Immunosurveillance and cancer: Epidemiological evidence. Br Med J 4:420–422, 1970PubMedGoogle Scholar
  13. 13.
    Weedon DD, Shorter RG, Ilstrup DM, Huizenga KA, Taylor WF: Crohn's disease and cancer. N Engl J Med 289:1099–1103, 1973PubMedGoogle Scholar

Copyright information

© Digestive Disease Systems, Inc. 1975

Authors and Affiliations

  • James L. Rosenberg
    • 1
  • Bernard Levin
    • 1
  • Alfred J. Wall
    • 1
  • Joseph B. Kirsner
    • 1
  1. 1.Section of Gastroenterology, Department of MedicineUniversity of ChicagoChicago

Personalised recommendations