title: Low-dose azathioprine effectively improves mucosal healing in Chinese patients with small bowel Crohn's disease.
abstract: OBJECTIVE
  To evaluate mucosal healing after 24-month low-dose azathioprine (AZA) treatment in Chinese patients with moderate small bowel Crohn's disease (CD).
  
  
  METHODS
  Patients with lesions mainly located at the ileum were screened by baseline multislice computed tomography enterography and anal-route double-balloon enteroscopy (DBE). They were naive to any immunomodulators and biological agents before the enrollment. Lesions from 150 cm of the terminal ileum proximal to ileocecal valve were assessed by DBE with the simple endoscopic score for CD (SES-CD) after 12 and 24 months of low-dose AZA treatment, respectively.
  
  
  RESULTS
  The average maximal tolerance dose of AZA was 61.8 ± 17.2 mg/day. The total rates of complete, near-complete, partial and no mucosal healing in 36 patients were 19.4%, 5.6%, 27.8% and 47.2% at month 12 and 30.6%, 25.0%, 33.3% and 11.1% at month 24, respectively. The baseline SES-CD (odds ratio [OR] 2.71, 95% confidence interval [CI] 1.11-6.63, P = 0.029) and duration of disease (OR 1.27, 95% CI 1.10-1.47, P = 0.001) were two relevant factors associated with the mucosal healing of patients with small bowel CD.
  
  
  CONCLUSIONS
  A 24-month low-dose AZA regimen as maintenance treatment in moderate small bowel CD could achieve a higher mucosal healing rate than that of 12-month treatment in Chinese patients, especially in those with duration of disease less than 12 months and a baseline SES-CD of 5 or 6.
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Li Fen
authors.initials: LF
authors.lastname: Yu
authors.forename: Jie
authors.initials: J
authors.lastname: Zhong
authors.forename: Shi Dan
authors.initials: SD
authors.lastname: Cheng
authors.forename: Yong Hua
authors.initials: YH
authors.lastname: Tang
authors.forename: Fei
authors.initials: F
authors.lastname: Miao
mesh_terms: D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage* / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D058582:Double-Balloon Enteroscopy / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007079:Ileitis / Q000188:drug therapy* / Q000473:pathology; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062326:Re-Epithelialization / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine
keywords: Crohn's disease; azathioprine; double-balloon enteroscopy; mucosal healing; small intestine