title: Is there still a room for azathioprine monotherapy in inflammatory bowel disease?
abstract: Azathioprine is an efficient maintenance treatment of IBD, able to maintain a complete clinical and anatomical remission in about one third of patients. However there are concerns regarding its long term tolerance, particularly myelosuppression and malignancy. Azathioprine is not required in about one third of Crohn's Disease patients and more than half of Ulcerative Colitis patients who will experience a mild disease course. In patients with more severe disease, although anti-TNF agents are more powerful and act more rapidly, there is a subset of patients with moderate-to-severe IBD without important anatomical damage who may achieve a prolonged steroid-free clinical and anatomical remission on azathioprine monotherapy. It is thus advised to initiate azathioprine monotherapy in these intermediate cases, and to continue azathioprine if anatomical remission is achieved.
authors.affiliation: 184, rue du Faubourg Saint- Antoine, 75571 PARIS Cedex 12, France. jacques.cosnes@sat.aphp.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Bourrier
authors.forename: Philippe
authors.initials: P
authors.lastname: Seksik
authors.forename: Jacques
authors.initials: J
authors.lastname: Cosnes
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001379:Azathioprine / Q000191:economics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000473:pathology; D000069285:Infliximab; D015122:Mercaptopurine / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D015122:Mercaptopurine; D001379:Azathioprine