Guidelines for prescribing azathioprine in dermatology.
Azathioprine has been available as an immunosuppressive agent for over 40 years, and current routine usage in dermatology is not restricted to licensed indications. Advances in understanding the metabolic fate of azathioprine have led to significant changes in prescribing practice and toxicity monitoring by U.K. dermatologists. The current state of knowledge concerning the use of azathioprine in dermatology is summarized, with identification of strength of evidence. Clinical indications and contraindications for azathioprine usage in dermatology are identified. Evidence-based recommendations are made for routine safety monitoring of patients treated with azathioprine, including pretreatment assessment of red blood cell thiopurine methyltransferase activity.
Anstey
A V
AV
Department of Dermatology, Royal Gwent Hospital, Cardiff Road, Newport, Gwent NP20 2UB, Wales, UK. alex.anstey@gwent.wales.nhs.uk
Wakelin
S
S
Reynolds
N J
NJ
D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D000075202:Contraindications; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007258:Informed Consent; D009369:Neoplasms / Q000139:chemically induced; D009894:Opportunistic Infections / Q000139:chemically induced; D012871:Skin Diseases / Q000188:drug therapy*
D007166:Immunosuppressive Agents; D001379:Azathioprine