Side effects of azathioprine in patients with Crohn's disease

European Journal of Gastroenterology and Hepatology

Volumn 16, Issue 2, 2004, Pages 207-212

  De Jong, Dirk J ^a   Goullet, Mohammed ^a   Naber, Ton H J ^a  

^a RADBOUD UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

Azathioprine; Crohn's disease; Inflammatory bowel disease; Toxicity

Indexed keywords

AZATHIOPRINE; MESALAZINE; PREDNISONE; ANTIINFLAMMATORY AGENT; IMMUNOSUPPRESSIVE AGENT;

ARTICLE; CLINICAL ARTICLE; CONTROLLED STUDY; CROHN DISEASE; FEVER; HOSPITALIZATION; HUMAN; LEUKOCYTE COUNT; LEUKOPENIA; PANCREATITIS; PNEUMONIA; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SIDE EFFECT; TREATMENT WITHDRAWAL; ADULT; AGE; AGED; CHEMICALLY INDUCED DISORDER; DRUG ADMINISTRATION; FEMALE; LIVER DISEASE; MALE; MIDDLE AGED; TIME;

ADULT; AGE FACTORS; AGED; ANTI-INFLAMMATORY AGENTS; AZATHIOPRINE; CROHN DISEASE; DRUG ADMINISTRATION SCHEDULE; FEMALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; LEUKOCYTE COUNT; LEUKOPENIA; LIVER DISEASES; MALE; MIDDLE AGED; PREDNISONE; RETROSPECTIVE STUDIES; TIME FACTORS;

EID: 2642580003     PISSN: 0954691X     EISSN: None     Source Type: Journal    
DOI: 10.1097/00042737-200402000-00014     Document Type: Article

References (22)

1. Pearson DC, May GR, Fick GH, Sutherland LR. Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med 1995; 123:132-142.
2. Sandborn W, Sutherland L, Pearson D, May G, Modigliani R, Prantera C. Azathioprine or 6-mercaptopurine for inducing remission of Crohn's disease. Cochrane Database Syst Rev 2000; 5:CD000545.
3. Present DH, Meltzer SJ, Krumholz MP, Wolke A, Korelitz BI. 6-Mercaptopurine in the management of inflammatory bowel disease: short- and long-term toxicity. Ann Intern Med 1989; 111:641-649.
4. Kirschner BS. Safety of azathioprine and 6-mercaptopurine in pediatric patients with inflammatory bowel disease. Gastroenterology 1998; 115:813-821.
5. Connell WR, Kamm MA, Ritchie JK, Lennard-Jones JE, Powell-Tuck J. Bone marrow toxicity caused by azathioprine in inflammatory bowel disease: 27 years of experience. Gut 1993; 34:1081-1085.
6. Connell WR, Kamm MA, Dickson M, Balkwill AM, Ritchie JK, Lennard Jones JE. Long-term neoplasia risk after azathioprine treatment in inflammatory bowel disease. Lancet 1994; 343:1249-1252.
7. Cuffari C, Theoret Y, Latour S, Seidman G. 6-Mercaptopurine metabolism in Crohn's disease: correlation with efficacy and toxicity. Gut 1996; 39:401-406.
8. Dubinsky MC, Lamothe S, Yang HY, Targan SR, Sinnett D, Theoret Y, et al. Pharmacogenomics and metabolite measurement for 6-mercaptopurine therapy in inflammatory bowel disease. Gastroenterology 2000; 118:705-713.
9. Weinshilboum RM, Sladek SL. Mercaptopurine pharmacogenetics: monogenic inheritance of erythrocyte thiopurine methyltransferase activity. Am J Hum Genet 1980; 32:651-662.
10. Colombel JF, Ferrari N, Debuysere H, Marteau P, Gendre JP, Bonaz B, et al. Genotypic analysis of thiopurine S-methyltransferase in patients with Crohn's disease and severe myelosuppression during azathioprine therapy. Gastroenterology 2000; 118:1025-1030.
11. Lennard L. TPMT in the treatment of Crohn's disease with azathioprine. Gut 2002; 51:143-146.
12. Nielsen OH, Vainer B, Rask-Madsen J. Review article: the treatment of inflammatory bowel disease with 6-mercaptopurine or azathioprine. Aliment Pharmacol Ther 2001; 15:1699-1708.
13. Sandborn WJ. Rational dosing of azathioprine and 6-mercaptopurine. Gut 2001; 48:591-592.
14. Dominguez OJ, Robledo T, Martinez-Cocera C, Alonso A, Cimarra M, Chamorro M, et al. Desensitization to azathioprine. J Investig Allergol Clin Immunol 1999; 9:337-338.
15. Korelitz BI, Zlatanic J, Goel F, Fuller S. Allergic reactions to 6-mercaptopurine during treatment of inflammatory bowel disease. J Clin Gastroenterol 1999; 28:341-344.
16. Wilkinson AH, Smith JL, Hunsicker LG, Tobacman J, Kapelanski DP, Johnson M, et al. Increased frequency of posttransplant lymphomas in patients treated with cyclosporine, azathioprine, and prednisone. Transplantation 1989; 47:293-296.
17. Silman AJ, Petrie J, Hazleman B, Evans SJ. Lymphoproliferative cancer and other malignancy in patients with rheumatoid arthritis treated with azathioprine: a 20 year follow up study. Ann Rheum Dis 1988; 47: 988-992.
18. Asten P, Barrett J, Symmons D. Risk of developing certain malignancies is related to duration of immunosuppressive drug exposure in patients with rheumatic diseases. J Rheumatol 1999; 26:1705-1714.
19. Lewis JD, Schwartz JS, Lichtenstein GR. Azathioprine for maintenance of remission in Crohn's disease: benefits outweigh the risk of lymphoma. Gastroenterology 2000; 118:1018-1024.
20. Yates CR, Krynetski EY, Loennechen T, Fessing MY, Tai HL, Pui CH, et al. Molecular diagnosis of thiopurine S-methyltransferase deficiency: genetic basis for azathioprine and mercaptopurine intolerance. Ann Intern Med 1997; 126:608-614.
21. Korelitz BI. Steroids may prevent leukopenia, interfering with response to IV azathioprine in treatment of Crohn's disease. Gastroenterology 2000; 118:1281-1282.
22. Szumlanski CL, Weinshilboum RM. Sulphasalazine inhibition of thiopurine methyltransferase: possible mechanism for interaction with 6-mercaptopurine and azathioprine. Br J Clin Pharmacol 1995; 39:456-459.