Azathioprine is effective for the maintenance of remission in Crohn's disease.
In this study, doctors from Denmark assessed whether patients kept in remission by azathioprine treatment for more than 2 years benefit from further treatment.
The team also explored the dose-response relationship.
They randomized 29 patients with inactive Crohn's disease after more than 2 years of azathioprine treatment to either azathioprine withdrawal or continued treatment.
The doctors measured whether or not the patients' relapsed. They defined relapse as a Crohn's disease activity index rise of ≥75 and a Crohn's disease activity index >150, or disease activity requiring intervention.
Overall, 28 patients completed the observation period or relapsed.
|85% of patients who continued treatment remained in remission.|
|Alimentary Pharmacology and Therapeutics|
There were 13 patients who continued azathioprine. The team found that 85% of these patients remained in remission.
Of the 15 patients who had their azathioprine withdrawn, only 47% remained in remission.
The team determined that in patients who had been treated with azathioprine >1.60 mg/kg/day the difference was greater.
They found that 89% of patients who continued their treatment remained in remission, compared with 33% of those who did not.
Dr Vilien and colleagues concluded, "Patients with Crohn's disease in remission after >2 years of continuous azathioprine treatment will benefit from further continued treatment".
"Further controlled studies with azathioprine doses <2 mg/kg/day are needed".