title: Azathioprine versus sulfasalazine in maintenance of remission in severe ulcerative colitis.
abstract: BACKGROUND
  Azathioprine is useful as a steroid-sparing drug in patients with ulcerative colitis. Its role as monotherapy in the maintenance of disease remission has not been evaluated.
  
  
  METHODS
  In this prospective, randomized, open-label study, 25 patients with severe ulcerative colitis received either azathioprine (2.5 mg/Kg/day; Group A, n = 12) or sulfasalazine (6 g/day; Group B, n = 13). All patients received oral corticosteroids in a tapering dosage schedule initially. Treatment failure was defined as either disease relapse or drug withdrawal because of adverse effects.
  
  
  RESULTS
  Five of 12 patients in Group A and 8 of 13 patients in Group B had sustained remission during the stipulated study period of 18 months (p = ns). Two patients in Group A had to stop azathioprine because of adverse effects (bone marrow suppression and acute pancreatitis). In Group A, all patients who had treatment failure developed it in the first half of the study while in Group B treatment failure occurred in both halves.
  
  
  CONCLUSIONS
  The relapse rate of ulcerative colitis on maintenance therapy with azathioprine or sulfasalazine is comparable; there was a trend towards earlier treatment failure with azathioprine.
authors.affiliation: Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab. ajitsood10@yahoo.co.in
authors.forename: Ajit
authors.initials: A
authors.lastname: Sood
authors.forename: Vandana
authors.initials: V
authors.lastname: Midha
authors.forename: Neena
authors.initials: N
authors.lastname: Sood
authors.forename: Gurcharan
authors.initials: G
authors.lastname: Avasthi
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007194:India; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012075:Remission, Spontaneous; D012720:Severity of Illness Index; D012460:Sulfasalazine / Q000009:adverse effects / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D012460:Sulfasalazine; D001379:Azathioprine