title: Azathioprine and anti-TNF alpha therapies in Crohn's disease: a review of pharmacology, clinical efficacy and safety.
abstract: Crohn's disease (CD), a chronic relapsing inflammatory condition of the intestines, is a common cause of gastrointestinal morbidity in young people. Although the aetiology of CD is unknown, host, genetic and environmental influences are clearly important. Glucocorticoids remain the mainstay of treatment for active CD, however only two-third of patients will respond and side effects are considerable. Surgery is often undesirable or impracticable and therefore alternative medical strategies have been sought. In recent years, there has been much interest in two areas of IBD therapy-the use of established immunomodulators, and the development of novel biological therapies. In this review, we have selected two areas of particular controversy-the use of purine analogues (azathioprine (AZA) and 6-mercaptopurine (6-MP)) and the introduction of anti-tumour necrosis factor alpha (TNFalpha) therapy and have examined the data for efficacy, safety and tolerability of these medications.
authors.affiliation: Gastrointestinal Unit, University Department of Medical Sciences, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, Scotland, UK. ian.arnott@doctors.net.uk
authors.forename: Ian D R
authors.initials: ID
authors.lastname: Arnott
authors.forename: David
authors.initials: D
authors.lastname: Watts
authors.forename: Jack
authors.initials: J
authors.lastname: Satsangi
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000494:pharmacology* / Q000627:therapeutic use; D001379:Azathioprine / Q000009:adverse effects* / Q000494:pharmacology* / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D000069285:Infliximab; D015122:Mercaptopurine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D015122:Mercaptopurine; D001379:Azathioprine