title: [Long term evolution of corticodependant and corticoresistant Crohn's disease patients treated by azzathioprine].
abstract: BACKGROUND
  Immunosupressors, particularly azathioprine, represents the therapeutic alternative in patients with corticodependant or corticoresistant Crohn's disease. The prescription of azathioprine in Tunisia is common, but there is not Tunisian studies evaluating the long term results of this drug in Crohn's disease patients.
  
  
  OBJECTIVE
  To evaluate the long term results of azathioprine treatment with determination of rates of relapses, surgery and need to corticosteroids in patients with corticodependant or corticoresistant Crohn's disease, and to look for predictive factors to theses events.
  
  
  METHODS
  A retrospective study on 12 years including all patients treated by azathioprine for corticodependant or corticoresistant Crohn's disease. We excluded the cases of follow up less than 6 months.
  
  
  RESULTS
  We studied 56 patients (46 corticodependant and 10 corticoresistant). Induction of remission was obtained in 89% of the cases. Concerning the long term results, the relapse rate was 60% of patients treated with azathioprine, with actuarial rates of 38% at one year, 65% at 5 years and 75% at 10 years. Need for corticosteroid treatment was estimated at 42% and need for surgical treatment was estimated at 24%. The only predictive factor for relapse was duration of treatment by azathioprine more than 36 months, with sensitivity of 93% and specificity of 50%.
  
  
  CONCLUSIONS
  Although an excellent result of azathioprine in induction remission, long term results showed deterioration of results of treatment. Physicians must be followed up Crohn's disease patients in order to rapidly detect and treat the clinical relapses of the disease.
authors.affiliation: Service de Gastroenterologie, Hopital la Rabta, Tunis, Tunisie.
authors.forename: Sami
authors.initials: S
authors.lastname: Karoui
authors.forename: Asma
authors.initials: A
authors.lastname: Hamrouni
authors.forename: Norsaf
authors.initials: N
authors.lastname: Bibani
authors.forename: Meriem
authors.initials: M
authors.lastname: Serghini
authors.forename: Jalel
authors.initials: J
authors.lastname: Boubaker
authors.forename: Azza
authors.initials: A
authors.lastname: Filali
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D001379:Azathioprine