Azathioprine in dermatology: a survey of current practice in the U.K.
Azathioprine has an important role in treatment of many inflammatory dermatoses. In view of the current emphasis on evidence-based medicine, we performed a questionnaire-based survey to establish current practice in the use of azathioprine by consultant dermatologists and associate specialists in the U.K. The response rate was 68%. In contrast with the manufacturer's recommendation, our data provide evidence that azathioprine is useful in the treatment of a wide variety of dermatological diseases. However, there is still a need for controlled trials in some conditions. The most common conditions treated were pemphigoid, pemphigus and atopic eczema. In addition, we found that only 13% of dermatologists prescribe azathioprine according to body weight. Most dermatologists felt that azathioprine was well tolerated. No one tested for thiopurine methyltransferase (TPMT) activity, which is thought to be a predictor of severe myelosuppression. The combination of prescribing azathioprine according to body weight and measuring TPMT activity would optimize efficacy and minimize potential severe myelotoxicity.
Tan
B B
BB
Department of Dermatology, North Staffordshire Hospital, Stoke-on-Trent, U.K.
Lear
J T
JT
Gawkrodger
D J
DJ
English
J S
JS
D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D001853:Bone Marrow / Q000187:drug effects; D003876:Dermatitis, Atopic / Q000188:drug therapy; D003880:Dermatology; D004334:Drug Administration Schedule; D019538:Health Care Surveys; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008780:Methyltransferases / Q000097:blood; D010391:Pemphigoid, Bullous / Q000188:drug therapy; D010392:Pemphigus / Q000188:drug therapy; D010818:Practice Patterns, Physicians'; D012871:Skin Diseases / Q000188:drug therapy*; D006113:United Kingdom
D007166:Immunosuppressive Agents; D008780:Methyltransferases; C022745:thiopurine methyltransferase; D001379:Azathioprine