Co-prescribing azathiopurine or 6-mercaptopurine and 5-aminosalicylate compounds in ulcerative colitis.
BACKGROUND
A total of 254 senior consultant gastroenterologists with valid e-mail addresses were identified from the membership list of the British Society of Gastroenterology (BSG) 2007.


METHODS
They were sent by e-mail a questionnaire which dealt with aspects of clinical practice and addressed cancer prevention in ulcerative colitis (UC). Replies were received from 97 clinicians (38% response rate).


RESULTS
Ninety-one (94%) advised patients with established UC to take 5-aminosalicylate (5-ASA) compounds for life. Seventy-two of the 91 (79%) clinicians co-prescribed 5-ASA compounds with immune modulators for patients with UC. Only 3 clinicians advised patients to take folic acid as a daily supplement. A median of 20% (interquartile range 10%-50%) of their patients with UC were co-prescribed a 5-ASA compound and azathioprine or 6-mercaptopurine. Of these, a median of 3.5% (interquartile 1%-5%) developed neutropenia.


CONCLUSIONS
Future research needs to be directed at the long-term maintenance treatment and to address questions about which drugs should be used, in what combinations, and with what frequencies.
Department of Digestive Diseases, Leicester General Hospital, Leicester, United Kingdom. jmaybe@tiscali.co.uk
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Mayberry
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Moshkovska
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Mayberry
D000328:Adult; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D019804:Mesalamine / Q000008:administration & dosage*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; C488629:azathiopurine; D019804:Mesalamine; D015122:Mercaptopurine