Azathioprine is widely used in Crohn's disease.
A major drawback is the occurrence of side-effects, especially acute pancreatitis.
Acute pancreatitis is rarely seen when azathioprine is used for other diseases than Crohn's disease.
Dr Weersma and colleagues from Amsterdam undertook a study to survey side-effects of azathioprine after liver or renal transplantation.
|Azathioprine-toxicity necessitating withdrawal occurred significantly more in rheumatoid arthritis, ulcerative colitis, and Crohn's disease|
|Alimentary Pharmacology and Therapeutics|
The investigators were looking for systemic lupus erythematosis, Wegener's granulomatosis, autoimmune hepatitis, rheumatoid arthritis, ulcerative colitis or Crohn's disease.
The researchers used a computerized search using the term 'azathioprine' or 'imuran' on the Hospital Information System of the university hospital Groningen.
The researchers obtained a list of 1564 patients that matched the criteria.
The researchers found that 11 of 224 patients with Crohn's disease experienced acute pancreatitis (4.9%) compared with 2 of 129 (1.5%) with autoimmune hepatitis, 2 of 388 (0.5%) after renal transplantation, and 1 of 254 (0.4%) after liver transplantation.
In addition, the research group found that acute pancreatitis was more prevalent in Crohn's disease compared with any other disease.
Azathioprine-toxicity necessitating withdrawal occurred significantly more in rheumatoid arthritis(78/317), ulcerative colitis (20/94) and Crohn's disease (52/224).
Toxicity requiring withdrawal was less significant in systemic lupus erythematosis (5/ 73), Wegener's granulomatosis (6/85), autoimmune hepatitis (8/129), after liver transplantation (17/254) and after renal transplantation (22/388).
Dr Weersma, speaking on behalf of his colleagues concluded, "Acute pancreatitis is strongly associated with Crohn's disease and rarely occurs with other underlying conditions."
In addition, "Overall azathioprine-induced toxicity and the necessity of withdrawal is more common in inflammatory bowel disease and rheumatoid arthritis compared with other diseases."