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 22 May 2018

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News

Response of perianal Crohn's disease to azathioprine or mercaptopurine

A third of patients with perianal Crohn's disease respond to azathioprine or 6-mercaptopurine therapy, find doctors in the November issue of the Diseases of the Colon and Rectum.

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In this study, doctors from France identified factors which predicted a response to azathioprine or 6-mercaptopurine in patients with perianal Crohn's disease.

The team assessed 94 patients (65 female, mean age 31 years) with active perianal Crohn's disease.

Patients were treated with azathioprine or 6-mercaptopurine for more than 6 months.

29% of patients were responders.
Diseases of the Colon and Rectum

The evolution of perianal lesions during treatment was analyzed retrospectively.

The team considered patients who had a clear anatomic improvement and who did not develop any perianal complications as responders.

The team found that after 3 years, the cumulative probabilities of remaining free of perianal complications and achieving a clear anatomic improvement were 0.47 and 0.4, respectively.

They determined that 29% of patients were responders to azathioprine or 6-mercaptopurine therapy.

The doctors identified the absence of fistula, duration of perianal disease shorter than 22 months, and age ≥40 years at inclusion as factors associated with response to therapy.

There was no correlation between the response of perianal lesions and the achievement of intestinal remission with azathioprine or 6-mercaptopurine.

Dr Thierry Lecomte's team concluded, "One-third of patients with perianal lesions of Crohn's disease demonstrated a clear improvement during azathioprine or 6-mercaptopurine therapy".

"Patients aged 40 years or older with a recent perianal disease and without fistula were the best responders".

Dis Colon Rectum 2003; 46(11): 1469-75
11 November 2003

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