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

Research output: Contribution to journal › Article › peer-review

77 Citations (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.

Original language	English
Pages (from-to)	1516-1524
Number of pages	9
Journal	Digestive Diseases and Sciences
Volume	51
Issue number	9
DOIs	https://doi.org/10.1007/s10620-005-9037-5
Publication status	Published - Sept 2006

Keywords

Azathioprine
Crohn's disease
Long-term immunosuppression
Ulcerative colitis

ASJC Scopus subject areas

Physiology
Gastroenterology

Access to Document

10.1007/s10620-005-9037-5

Cite this

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, vol. 51, no. 9, pp. 1516-1524. https://doi.org/10.1007/s10620-005-9037-5

@article{8a6507672d8241aaaa6908f968fe51a4,

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

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.",

keywords = "Azathioprine, Crohn's disease, Long-term immunosuppression, Ulcerative colitis",

author = "Holtmann, {Martin H.} and Frank Krummenauer and Christina Claas and Kristina Kremeyer and Dirk Lorenz and Olivia Rainer and Iris Vogel and Ulrich B{\"o}cker and Stephan B{\"o}hm and Carsten B{\"u}ning and Rainer Duchmann and Guido Gerken and Hans Herfarth and Norbert L{\"u}gering and Wolfgang Kruis and Max Reinshagen and Jan Schmidt and Andreas Stallmach and J{\"u}rgen Stein and Andreas Sturm and Galle, {Peter R.} and Hommes, {Daan W.} and Geert D'Haens and Paul Rutgeerts and Neurath, {Markus F.}",

year = "2006",

month = sep,

doi = "10.1007/s10620-005-9037-5",

language = "English",

volume = "51",

pages = "1516--1524",

journal = "Digestive Diseases and Sciences",

issn = "0163-2116",

publisher = "Plenum Publishers",

number = "9",

}

TY - JOUR

T1 - Long-term effectiveness of azathioprine in IBD beyond 4 years

T2 - A european multicenter study in 1176 patients

AU - Holtmann, Martin H.

AU - Krummenauer, Frank

AU - Claas, Christina

AU - Kremeyer, Kristina

AU - Lorenz, Dirk

AU - Rainer, Olivia

AU - Vogel, Iris

AU - Böcker, Ulrich

AU - Böhm, Stephan

AU - Büning, Carsten

AU - Duchmann, Rainer

AU - Gerken, Guido

AU - Herfarth, Hans

AU - Lügering, Norbert

AU - Kruis, Wolfgang

AU - Reinshagen, Max

AU - Schmidt, Jan

AU - Stallmach, Andreas

AU - Stein, Jürgen

AU - Sturm, Andreas

AU - Galle, Peter R.

AU - Hommes, Daan W.

AU - D'Haens, Geert

AU - Rutgeerts, Paul

AU - Neurath, Markus F.

PY - 2006/9

Y1 - 2006/9

N2 - 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.

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.

KW - Azathioprine

KW - Crohn's disease

KW - Long-term immunosuppression

KW - Ulcerative colitis

UR - http://www.scopus.com/inward/record.url?scp=33748626581&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748626581&partnerID=8YFLogxK

U2 - 10.1007/s10620-005-9037-5

DO - 10.1007/s10620-005-9037-5

M3 - Article

C2 - 16927148

AN - SCOPUS:33748626581

SN - 0163-2116

VL - 51

SP - 1516

EP - 1524

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

IS - 9

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this