Azathioprine dose escalation in inflammatory bowel disease

Alimentary Pharmacology & Therapeutics
C K RaynerM A Kamm

Abstract

Forty per cent of patients with inflammatory bowel disease fail to respond to standard dose azathioprine (2 mg/kg/day). To evaluate the efficacy and safety of increasing the azathioprine dose according to a fixed schedule and guided by clinical response and adverse effects. We reviewed the records of all patients with inflammatory bowel disease treated by a single clinician over 6 years, unresponsive to at least 3 months treatment with standard dose azathioprine, and whose dose was subsequently increased. Forty patients (27 male; 24 Crohn's, 16 ulcerative colitis) with chronic active disease or recurrent flares despite standard dose azathioprine for a median 8 months (range 3-114) increased their dose from a median 2.02 (1.61-3.19) mg/kg/day to 2.72 (2.37-3.99) mg/kg/day in one to four increments of 0.5 mg/kg/day, and were followed over a median 6 (0.5-54) months. Eleven of the 40 patients (seven Crohn's, four ulcerative colitis) responded or had reduced frequency of flare-ups at the end of follow-up, while 17 of the 40 patients had no benefit. Response was more likely for maximum doses < or =2.5 mg/kg/day (six of 11 patients) than for doses >2.5 mg/kg/day (five of 29 patients) (P = 0.042). Twelve patients (11 of whom received ...Continue Reading

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Nov 14, 2007·Gut·UNKNOWN BMJ Group
Sep 28, 2013·Journal of Translational Medicine·Jianghong WuShudong Xiao
Mar 8, 2013·World Journal of Gastroenterology : WJG·Pascal FreiGerhard Rogler
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Mar 27, 2018·Gastroenterology Research and Practice·Min Seob KwakSuk-Kyun Yang

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