Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: Results from a european multicenter study in 1,176 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/s10620-009-0846-9

Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: Results from a european multicenter study in 1,176 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

35 Citations (Scopus)

Abstract

In a survey comprising 1,176 patients with inflammatory bowel disease (IBD) we recently showed that azathioprine (AZA) beyond 4 years is beneficial in ulcerative colitis (UC) patients and in a subset of Crohn's disease (CD) patients. Here, we show for the first time that azathioprine responsiveness depends on body mass index (BMI). The relationship is reciprocal in UC and CD, with a better outcome in UC patients with a BMI<25 and in CD patients with a BMI>25. These observations are particularly interesting considering the evolving concept of a relationship between fatty metabolism and immune regulation. Additionally, we show that CD patients, but not UC patients, respond better to AZA when it is started in clinical remission. This observation may support data favouring a "hit hard and early" regime in CD. Finally, we were able to demonstrate a decrease in the incidence of CD-related complications requiring surgery through treatment with AZA.

Original language	English
Pages (from-to)	1066-1078
Number of pages	13
Journal	Digestive Diseases and Sciences
Volume	55
Issue number	4
DOIs	https://doi.org/10.1007/s10620-009-0846-9
Publication status	Published - Apr 2010

Keywords

Azathioprine
Body mass index
Crohn's disease
Disease activity
Ulcerative colitis

ASJC Scopus subject areas

Physiology
Gastroenterology

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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. (2010). Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: Results from a european multicenter study in 1,176 patients. Digestive Diseases and Sciences, 55(4), 1066-1078. https://doi.org/10.1007/s10620-009-0846-9

Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: Results from a european multicenter study in 1,176 patients. / Holtmann, Martin H.; Krummenauer, Frank; Claas, Christina et al.
In: Digestive Diseases and Sciences, Vol. 55, No. 4, 04.2010, p. 1066-1078.

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

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 2010, 'Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: Results from a european multicenter study in 1,176 patients', Digestive Diseases and Sciences, vol. 55, no. 4, pp. 1066-1078. https://doi.org/10.1007/s10620-009-0846-9

Holtmann MH, Krummenauer F, Claas C, Kremeyer K, Lorenz D, Rainer O et al. Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: Results from a european multicenter study in 1,176 patients. Digestive Diseases and Sciences. 2010 Apr;55(4):1066-1078. doi: 10.1007/s10620-009-0846-9

Holtmann, Martin H. ; Krummenauer, Frank ; Claas, Christina et al. / Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine : Results from a european multicenter study in 1,176 patients. In: Digestive Diseases and Sciences. 2010 ; Vol. 55, No. 4. pp. 1066-1078.

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abstract = "In a survey comprising 1,176 patients with inflammatory bowel disease (IBD) we recently showed that azathioprine (AZA) beyond 4 years is beneficial in ulcerative colitis (UC) patients and in a subset of Crohn's disease (CD) patients. Here, we show for the first time that azathioprine responsiveness depends on body mass index (BMI). The relationship is reciprocal in UC and CD, with a better outcome in UC patients with a BMI<25 and in CD patients with a BMI>25. These observations are particularly interesting considering the evolving concept of a relationship between fatty metabolism and immune regulation. Additionally, we show that CD patients, but not UC patients, respond better to AZA when it is started in clinical remission. This observation may support data favouring a {"}hit hard and early{"} regime in CD. Finally, we were able to demonstrate a decrease in the incidence of CD-related complications requiring surgery through treatment with AZA.",

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Significant differences between crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: Results from a european multicenter study in 1,176 patients

Abstract

Keywords

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