Abstract

JULIAO B, Fabián et al. Clinical Efficacy of Azathioprine (AZA) for Treatment of Mild to Moderate Ulcerative Colitis (UC) in Patients Who Have Responded Inadequately to Steroids. Rev Col Gastroenterol [online]. 2015, vol.30, n.3, pp.279-284. ISSN 0120-9957.

Introduction: Because there are very few studies of the use of azathioprine (AZA) for treatment of ulcerative colitis, and most are more than a decade old, we need to establish the efficacy of AZA in our environment for patients who have responded inadequately to steroids. Objective: The objective of this study is to evaluate short and long term clinical responses to AZA by ulcerative colitis patients in our population who have had inadequate responses to treatment with steroids. Materials and Methods: This is a retrospective study based on a database review of the medical records of 215 ulcerative colitis patients treated at the Hospital Pablo Tobon Uribe between August 2001 and May 2014. Sixty-nine patients (32%) had received AZA, and 30 patients had received at least 3 months of treatment with AZA at the optimal dose of at least 2.0 mg/kg after having responded inadequately to treatment with steroids. This group was included in the study. Results: The median follow-up time was 20 months with a range from three months to 72 months. After three months of treatment, clinical remission was found in 17 patients (57%) out of 30 patients, and partial responses were found in 12 out of 30 subjects (40%). A year after the initial follow-up, 16 patients (53%) maintained clinical remission, three (10%) continued to have partial responses, and five (17%) had relapsed and had received biological therapy. Sixteen patients (53%) achieved one year with steroid treatment suspended and no patients required colectomies. Conclusions: This study demonstrates a clinical remission rate of 53% for patients with mild to moderate ulcerative colitis who were treated with AZA. One year follow-ups showed that continuous suspension of steroid treatment had been achieved in 53% of patients. AZA is an inexpensive and safe therapeutic option which can be considered prior to initiating biological therapy for these patients

Keywords : Ulcerative colitis; azathioprine; clinical remission; steroid suspension.

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