Long-term effectiveness of azathioprine in IBD beyond 4 years: A european multicenter study in 1176 patients

Martin H. Holtmann; Frank Krummenauer; Christina Claas; Kristina Kremeyer; Dirk Lorenz; Olivia Rainer; Iris Vogel; Ulrich Böcker; Stephan Böhm; Carsten Büning; Rainer Duchmann; Guido Gerken; Hans Herfarth; Norbert Lügering; Wolfgang Kruis; Max Reinshagen; Jan Schmidt; Andreas Stallmach; Jürgen Stein; Andreas Sturm; Peter R. Galle; Daan W. Hommes; Geert D'Haens; Paul Rutgeerts; Markus F. Neurath

doi:10.1007/s10620-005-9037-5

Long-term effectiveness of azathioprine in IBD beyond 4 years: A european multicenter study in 1176 patients

Martin H. Holtmann, Frank Krummenauer, Christina Claas, Kristina Kremeyer, Dirk Lorenz, Olivia Rainer, Iris Vogel, Ulrich Böcker, Stephan Böhm, Carsten Büning, Rainer Duchmann, Guido Gerken, Hans Herfarth, Norbert Lügering, Wolfgang Kruis, Max Reinshagen, Jan Schmidt, Andreas Stallmach, Jürgen Stein, Andreas SturmPeter R. Galle, Daan W. Hommes, Geert D'Haens, Paul Rutgeerts, Markus F. Neurath

Klinik für Innere Medizin - Gastroenterologie, Diabetologie und Hepatologie

Publikation › Begutachtung

77 Zitate (Scopus)

Abstract

In Crohn's disease the optimal duration of azathioprine treatment is still controversial and for ulcerative colitis only limited data are available to support its efficacy. Charts of 1176 patients with IBD from 16 European centers were analyzed. Flare incidences and steroid dosages were assessed for the time before and during treatment and after discontinuation. Within the first 4 years, azathioprine suppressed flare incidence and steroid consumption in both diseases (P∈<∈0.001). While in CD discontinuation after 3-4 years did not lead to reactivation, this was the case in UC. However, continuation beyond 4 years further improved clinical activity in CD and steroid requirement in both diseases (P∈<∈0.001). Discontinuation of azathioprine may thus be considered after 3-4 years in CD patients in complete remission without steroid requirement. In all other CD patients and for UC patients in general, continuation seems beneficial. These results support a novel differential algorithm for long-term azathioprine therapy in IBD.

Originalsprache	English
Seiten (von - bis)	1516-1524
Seitenumfang	9
Fachzeitschrift	Digestive Diseases and Sciences
Jahrgang	51
Ausgabenummer	9
DOIs	https://doi.org/10.1007/s10620-005-9037-5
Publikationsstatus	Published - Sept. 2006

ASJC Scopus subject areas

Physiologie
Gastroenterologie

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10.1007/s10620-005-9037-5

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Holtmann, M. H., Krummenauer, F., Claas, C., Kremeyer, K., Lorenz, D., Rainer, O., Vogel, I., Böcker, U., Böhm, S., Büning, C., Duchmann, R., Gerken, G., Herfarth, H., Lügering, N., Kruis, W., Reinshagen, M., Schmidt, J., Stallmach, A., Stein, J., ... Neurath, M. F. (2006). Long-term effectiveness of azathioprine in IBD beyond 4 years: A european multicenter study in 1176 patients. Digestive Diseases and Sciences, 51(9), 1516-1524. https://doi.org/10.1007/s10620-005-9037-5

Holtmann, MH, Krummenauer, F, Claas, C, Kremeyer, K, Lorenz, D, Rainer, O, Vogel, I, Böcker, U, Böhm, S, Büning, C, Duchmann, R, Gerken, G, Herfarth, H, Lügering, N, Kruis, W, Reinshagen, M, Schmidt, J, Stallmach, A, Stein, J, Sturm, A, Galle, PR, Hommes, DW, D'Haens, G, Rutgeerts, P & Neurath, MF 2006, 'Long-term effectiveness of azathioprine in IBD beyond 4 years: A european multicenter study in 1176 patients', Digestive Diseases and Sciences, Jg. 51, Nr. 9, S. 1516-1524. https://doi.org/10.1007/s10620-005-9037-5

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abstract = "In Crohn's disease the optimal duration of azathioprine treatment is still controversial and for ulcerative colitis only limited data are available to support its efficacy. Charts of 1176 patients with IBD from 16 European centers were analyzed. Flare incidences and steroid dosages were assessed for the time before and during treatment and after discontinuation. Within the first 4 years, azathioprine suppressed flare incidence and steroid consumption in both diseases (P∈<∈0.001). While in CD discontinuation after 3-4 years did not lead to reactivation, this was the case in UC. However, continuation beyond 4 years further improved clinical activity in CD and steroid requirement in both diseases (P∈<∈0.001). Discontinuation of azathioprine may thus be considered after 3-4 years in CD patients in complete remission without steroid requirement. In all other CD patients and for UC patients in general, continuation seems beneficial. These results support a novel differential algorithm for long-term azathioprine therapy in IBD.",

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AB - In Crohn's disease the optimal duration of azathioprine treatment is still controversial and for ulcerative colitis only limited data are available to support its efficacy. Charts of 1176 patients with IBD from 16 European centers were analyzed. Flare incidences and steroid dosages were assessed for the time before and during treatment and after discontinuation. Within the first 4 years, azathioprine suppressed flare incidence and steroid consumption in both diseases (P∈<∈0.001). While in CD discontinuation after 3-4 years did not lead to reactivation, this was the case in UC. However, continuation beyond 4 years further improved clinical activity in CD and steroid requirement in both diseases (P∈<∈0.001). Discontinuation of azathioprine may thus be considered after 3-4 years in CD patients in complete remission without steroid requirement. In all other CD patients and for UC patients in general, continuation seems beneficial. These results support a novel differential algorithm for long-term azathioprine therapy in IBD.

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Long-term effectiveness of azathioprine in IBD beyond 4 years: A european multicenter study in 1176 patients

Abstract

ASJC Scopus subject areas

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