Low-dose azathioprine is effective in maintaining remission among Chinese patients with Crohn's disease.
BACKGROUND
Azathiopurine (AZA) is efficacious for maintenance remission of Crohn's disease (CD) at the standard dose of 2.0-2.5 mg/kg for Caucasian. It has been reported that the lower dose (1.0-2.0 mg/kg) in some Asian countries was as effective as the standard dose. In the present study we analyzed the efficacy of <1.0 mg/kg AZA in maintaining remission for Chinese patients.


METHODS
The clinical data of all CD patients were reviewed from 1993 to December 2012. The patients who initiated AZA treatment and were followed for ≥ 2 years with complete medical data were included. We divided the patients into two groups according to their initial dose: <1.0 mg/kg group and 1.0-2.0 mg/kg group.


RESULTS
Among 77 patients, 39 (50.6%) started treatment with <1.0 mg/kg AZA and 38 (49.4%) with 1.0-2.0 mg/kg. The mean dose of <1.0 mg/kg group remained under 1.0 mg/kg at 6, 12 and 24 months, even if the doses were adjusted according to efficacy and tolerance. The remission rate in patients of <1.0 mg/kg group was significantly higher than that in those of 1.0-2.0 mg/kg group (P = 0.025). A dose of <1.0 mg/kg AZA was more commonly associated with male gender, older age, heavier body weight and L1 location. Adverse events were observed in 21 of 77 patients (27.3%) and no significant difference in occurrence of adverse events or leucopenia between two groups.


CONCLUSIONS
<1.0 mg/kg AZA was effective as 1.0-2.0 mg/kg in maintaining remission among Chinese patients with CD.
Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health (Shanghai Jiao-Tong University), Shanghai, China. dryangch3@163.com.
Jianghong
J
Wu
Yan
Y
Gao
Chuanhua
C
Yang
Xueqing
X
Yang
Xuhang
X
Li
Shudong
S
Xiao
D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D001379:Azathioprine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D002681:China; D003424:Crohn Disease / Q000188:drug therapy*; D003657:Decision Making; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D028761:Withholding Treatment; D055815:Young Adult
D007166:Immunosuppressive Agents; D001379:Azathioprine