Meta‐analysis: the efficacy of azathioprine and mercaptopurine in ulcerative colitis

Background  Debate exists regarding to whether thiopurine therapy is as effective in ulcerative colitis (UC) as it is in Crohn's disease.

[1]  J. Gisbert,et al.  Comparative effectiveness of azathioprine in Crohn’s disease and ulcerative colitis: prospective, long‐term, follow‐up study of 394 patients , 2008, Alimentary pharmacology & therapeutics.

[2]  I. García,et al.  Eficacia del mantenimiento con azatioprina sin ciclosporina oral tras un brote grave de colitis ulcerosa refractario a esteroides intravenosos , 2008 .

[3]  M. Woodward,et al.  How are Azathioprine and 6‐mercaptopurine dosed by gastroenterologists? Results of a survey of clinical practice , 2008, Inflammatory bowel diseases.

[4]  S. Hutfless,et al.  Mortality by medication use among patients with inflammatory bowel disease, 1996-2003. , 2007, Gastroenterology.

[5]  M. A. Peris,et al.  Optimización del tratamiento inmunomodulador con azatioprina o 6-mercaptopurina en pacientes con enfermedad inflamatoria intestinal , 2007 .

[6]  A. Sood,et al.  Long term results of use of azathioprine in patients with ulcerative colitis in India. , 2006, World journal of gastroenterology.

[7]  J. Mate,et al.  Systematic review: infliximab therapy in ulcerative colitis , 2006, Alimentary pharmacology & therapeutics.

[8]  Sanjoy Banerjee,et al.  Evolution of Thiopurine Use in Pediatric Inflammatory Bowel Disease in an Academic Center: Role of Thiopurine Methyltransferase and 6-Mercaptopurine Metabolite Measurements , 2006, Journal of pediatric gastroenterology and nutrition.

[9]  T. Dassopoulos,et al.  Steroid dependent ulcerative colitis: azathioprine use is finally "evidence-based". , 2006, Inflammatory bowel diseases.

[10]  A. Bousvaros,et al.  5‐Aminosalicylate therapy is associated with higher 6‐thioguanine levels in adults and children with inflammatory bowel disease in remission on 6‐mercaptopurine or azathioprine , 2006, Inflammatory bowel diseases.

[11]  B. Sands.  Immunosuppressive drugs in ulcerative colitis: twisting facts to suit theories? , 2006, Gut.

[12]  W. Tremaine,et al.  American Gastroenterological Association Institute technical review on corticosteroids, immunomodulators, and infliximab in inflammatory bowel disease. , 2006, Gastroenterology.

[13]  S. Ghosh,et al.  Is thiopurine therapy in ulcerative colitis as effective as in Crohn’s disease? , 2005, Gut.

[14]  J. Glas,et al.  The leukocyte count predicts the efficacy of treatment with azathioprine in inflammatory bowel disease. , 2005, European journal of medical research.

[15]  G. Porro,et al.  A rare cause of diuretic refractory ascites , 2005, Gut.

[16]  P. Banks,et al.  Are Patients with Inflammatory Bowel Disease Receiving Optimal Care? , 2005, The American Journal of Gastroenterology.

[17]  V. Annese,et al.  Appropriateness of immunosuppressive drugs in inflammatory bowel diseases assessed by RAND method: Italian Group for IBD (IG-IBD) position statement. , 2005, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[18]  B. Bonaz,et al.  6‐Tioguanine monitoring in steroid‐dependent patients with inflammatory bowel diseases receiving azathioprine , 2005, Alimentary pharmacology & therapeutics.

[19]  L. Griffel,et al.  The Ten-year Single-center Experience With 6-Mercaptopurine in the Treatment of Inflammatory Bowel Disease , 2005, Journal of clinical gastroenterology.

[20]  A. von Eckardstein,et al.  Therapeutic drug monitoring of thiopurine drugs in patients with inflammatory bowel disease or autoimmune hepatitis , 2004, European journal of gastroenterology & hepatology.

[21]  S. Hanauer,et al.  The long‐term management of ulcerative colitis , 2004 .

[22]  H. Ogata,et al.  [A systematic review of the clinical effectiveness of azathioprine in patients with ulcerative colitis]. , 2004, Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan.

[23]  D. Sanders,et al.  Clinical significance of azathioprine active metabolite concentrations in inflammatory bowel disease , 2004, Gut.

[24]  A. López-Sanromán,et al.  Efficacy and safety of thiopurinic immunomodulators (azathioprine and mercaptopurine) in steroid‐dependent ulcerative colitis , 2004, Alimentary pharmacology & therapeutics.

[25]  K. Petraki,et al.  A Prospective Randomized Observer-Blind 2-Year Trial of Azathioprine Monotherapy versus Azathioprine and Olsalazine for the Maintenance of Remission of Steroid-Dependent Ulcerative Colitis , 2004, American Journal of Gastroenterology.

[26]  Richard E Thompson,et al.  Thiopurine methyltransferase activity influences clinical response to azathioprine in inflammatory bowel disease. , 2004, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[27]  P. Rutgeerts,et al.  Long-term Outcome of Treatment with Intravenous Cyclosporin in Patients With Severe Ulcerative Colitis , 2004, Inflammatory bowel diseases.

[28]  B. Korelitz,et al.  A Search for the Optimal Duration of Treatment with 6-Mercaptopurine for Ulcerative Colitis , 2004, American Journal of Gastroenterology.

[29]  M. Rizzetto,et al.  [Need for hospital admission in patients with ulcerative colitis during maintenance with azathioprine]. , 2004, Minerva gastroenterologica e dietologica.

[30]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[31]  H. Asakura.  Role and side-effects of TPMT polymorphisms of 6-MP and azathioprine in the treatment of steroid-resistant and -dependent ulcerative colitis , 2003, Journal of Gastroenterology.

[32]  T. Hibi,et al.  Low-dose azathioprine is effective and safe for maintenance of remission in patients with ulcerative colitis , 2003, Journal of Gastroenterology.

[33]  K. Katsanos,et al.  A report on efficacy and safety of azathioprine in a group of inflammatory bowel disease patients in northwest Greece. , 2003, Hepato-gastroenterology.

[34]  M. Verhoef,et al.  A national survey on the patterns of treatment of inflammatory bowel disease in Canada , 2003, BMC gastroenterology.

[35]  A. Sood,et al.  Azathioprine versus sulfasalazine in maintenance of remission in severe ulcerative colitis. , 2003, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology.

[36]  E. Cabré,et al.  Azathioprine without oral ciclosporin in the long‐term maintenance of remission induced by intravenous ciclosporin in severe, steroid‐refractory ulcerative colitis , 2002, Alimentary pharmacology & therapeutics.

[37]  O. Paoluzi,et al.  Azathioprine or methotrexate in the treatment of patients with steroid‐dependent or steroid‐resistant ulcerative colitis: results of an open‐label study on efficacy and tolerability in inducing and maintaining remission , 2002, Alimentary pharmacology & therapeutics.

[38]  K. Fellermann,et al.  Response of Refractory Colitis to Intravenous or Oral Tacrolimus (FK506) , 2002, Inflammatory bowel diseases.

[39]  O. Zmora,et al.  Immunosuppressants and operation in ulcerative colitis1 , 2002 .

[40]  M. A. Kamm,et al.  Maintenance of remission in ulcerative colitis , 2002, Alimentary pharmacology & therapeutics.

[41]  M. Kamm.  Review article: maintenance of remission in ulcerative colitis. , 2002, Alimentary pharmacology & therapeutics.

[42]  G. Actis,et al.  An audit of the immunosuppressive management of ulcerative colitis. A retrospective chart review from a referral Day-Hospital of Gastro-enterology. , 2002, Minerva gastroenterologica e dietologica.

[43]  D. Jewell,et al.  The efficacy of azathioprine for the treatment of inflammatory bowel disease: a 30 year review , 2002, Gut.

[44]  P. Beau,et al.  [Compared azathioprine efficacy in ulcerative colitis and in Crohn's disease]. , 2002, Gastroenterologie clinique et biologique.

[45]  T. Hibi,et al.  Do immunosuppressants really work as maintenance therapy after the achievement of remission of severe ulcerative colitis? , 2002, Journal of Gastroenterology.

[46]  A. Sood,et al.  The beneficial effect of azathioprine on maintenance of remission in severe ulcerative colitis , 2002, Journal of Gastroenterology.

[47]  R. Zinicola,et al.  Immunosuppressants in distal ulcerative colitis , 2002 .

[48]  C. Bernstein,et al.  Use of pharmaceuticals by inflammatory bowel disease patients: a population-based study , 2001, American Journal of Gastroenterology.

[49]  S. Campbell,et al.  Effective maintenance of inflammatory bowel disease remission by azathioprine does not require concurrent 5-aminosalicylate therapy , 2001, European journal of gastroenterology & hepatology.

[50]  B. Vainer,et al.  The treatment of inflammatory bowel disease with 6‐mercaptopurine or azathioprine , 2001, Alimentary pharmacology & therapeutics.

[51]  S. Campbell,et al.  Is neutropenia required for effective maintenance of remission during azathioprine therapy in inflammatory bowel disease? , 2001, European journal of gastroenterology & hepatology.

[52]  G. Actis,et al.  Safety and efficacy of azathioprine in the maintenance of ciclosporin‐induced remission of ulcerative colitis , 2001, Alimentary pharmacology & therapeutics.

[53]  A. Zinsmeister,et al.  The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study. , 2001, Gastroenterology.

[54]  T. Bayless,et al.  Utilisation of erythrocyte 6-thioguanine metabolite levels to optimise azathioprine therapy in patients with inflammatory bowel disease , 2001, Gut.

[55]  W. Sandborn,et al.  Intravenous azathioprine in severe ulcerative colitis: a pilot study , 2000, American Journal of Gastroenterology.

[56]  R. Moreno-otero,et al.  6‐Mercaptopurine or methotrexate added to prednisone induces and maintains remission in steroid‐dependent inflammatory bowel disease , 2000, European journal of gastroenterology & hepatology.

[57]  Z H Khan,et al.  Retrospective Case Series Analysis of Patients with Inflammatory Bowel Disease on Azathioprine , 2000, Digestion.

[58]  M. Bala,et al.  Annual cost of care for Crohn's disease: a payor perspective , 2000, American Journal of Gastroenterology.

[59]  M. Neurath,et al.  Mycophenolate mofetil versus azathioprine in patients with chronic active Ulcerative colitis : A 12-month pilot study , 2000 .

[60]  B. Korelitz.  A history of immunosuppressive drugs in the treatment of inflammatory bowel disease: origins at The Mount Sinai Hospital. , 2000, The Mount Sinai journal of medicine, New York.

[61]  M. Neurath,et al.  Mycophenolate mofetil versus azathioprine in patients with chronic active ulcerative colitis: a 12-month pilot study , 2000, American Journal of Gastroenterology.

[62]  J. Rask-Madsen,et al.  IOIBD questionnaire on the clinical use of azathioprine, 6‐mercaptopurine, cyclosporin A and methotrexate in the treatment of inflammatory bowel diseases , 2000, European journal of gastroenterology & hepatology.

[63]  Thomson,et al.  Low‐dose intravenous azathioprine may be effective in the management of acute fulminant colitis complicating inflammatory bowel disease , 1999, Alimentary pharmacology & therapeutics.

[64]  S. Hanauer,et al.  Intravenous cyclosporin in ulcerative colitis: a five-year experience , 1999, American Journal of Gastroenterology.

[65]  Williams,et al.  Immunosuppressive therapy for ulcerative colitis: results of a nation‐wide survey among consultant physician members of the British Society of Gastroenterology , 1999, Alimentary pharmacology & therapeutics.

[66]  G. Fick,et al.  Azathioprine for maintaining remission of Crohn's disease. , 1998, The Cochrane database of systematic reviews.

[67]  G. Porro,et al.  Azathioprine in steroid-resistant and steroid-dependent ulcerative colitis. , 1997, Journal of clinical gastroenterology.

[68]  E. Cabré,et al.  Azathioprine is useful in maintaining long-term remission induced by intravenous cyclosporine in steroid-refractory severe ulcerative colitis. , 1996, The American journal of gastroenterology.

[69]  Peppercom Ma.  6-mercaptopurine for the management of ulcerative colitis: a concept whose time has come. , 1996 .

[70]  C. Bodian,et al.  The long-term outcome of ulcerative colitis treated with 6-mercaptopurine. , 1996, The American journal of gastroenterology.

[71]  A R Jadad,et al.  Assessing the quality of reports of randomized clinical trials: is blinding necessary? , 1996, Controlled clinical trials.

[72]  P. Nos,et al.  [Efficacy of 6-mercaptopurine in the treatment of inflammatory bowel disease]. , 1995, Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva.

[73]  A. Axon,et al.  Randomised controlled trial of azathioprine withdrawal in ulcerative colitis. , 1992, BMJ.

[74]  S. Ardizzone,et al.  Azathioprine in the treatment of ulcerative colitis. , 1991, Journal of clinical gastroenterology.

[75]  H. Winter,et al.  Azathioprine in the treatment of children with inflammatory bowel disease. , 1990, The Journal of pediatrics.

[76]  Adler Dj,et al.  The therapeutic efficacy of 6-mercaptopurine in refractory ulcerative colitis. , 1990 .

[77]  E. Prokipchuk,et al.  Azathioprine therapy in chronic ulcerative colitis. , 1990, Journal of clinical gastroenterology.

[78]  A. Axon,et al.  The role of azathioprine in the management of ulcerative colitis , 1990, Diseases of the colon and rectum.

[79]  J. Lennard-jones,et al.  Controlled trial of azathioprine in chronic ulcerative colitis. , 1982, British medical journal.

[80]  S. Mereu,et al.  [Immunosuppressive therapy in ulcerative rectocolitis. Long-term assessment of results]. , 1982, Minerva medica.

[81]  Y. Niv,et al.  Imuran in the treatment of ulcerative colitis. , 1981, The American journal of gastroenterology.

[82]  B. Levin,et al.  A controlled trial of azathioprine in the management of chronic ulcerative colitis. , 1975, Gastroenterology.

[83]  R. Caprilli,et al.  A double-blind comparison of the effectiveness of azathioprine and sulfasalazine in idiopathic proctocolitis , 1975, The American Journal of Digestive Diseases.

[84]  D. Jewell,et al.  Azathioprine in Ulcerative Colitis: Final Report on Controlled Therapeutic Trial , 1974, British medical journal.

[85]  K. Teleki,et al.  [Immunosuppressive therapy of ulcerative colitis]. , 1972, Orvosi hetilap.

[86]  J. Ra.  Immunosuppressive therapy in ulcerative colitis. , 1969 .

[87]  E. Theodor,et al.  Treatment of Ulcerative Colitis with Azathioprine , 1968, British medical journal.

[88]  M. Latorre Sánchez,et al.  [Effectiveness of maintenance azathioprine therapy without oral cyclosporine after severe attacks of ulcerative colitis refractory to endovenous steroids]. , 2008, Gastroenterologia y hepatologia.

[89]  A. Timmer,et al.  Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis. , 2007, The Cochrane database of systematic reviews.

[90]  P. Nos Mateu,et al.  [Optimization of immunomodulatory treatment with azathioprine or 6-mercaptopurine in inflammatory bowel disease]. , 2007, Gastroenterologia y hepatologia.

[91]  S. Hanauer.  Review article: the long-term management of ulcerative colitis. , 2004, Alimentary pharmacology & therapeutics.

[92]  J. Gisbert,et al.  Preguntas y respuestas sobre el papel de la azatioprina y la 6-mercaptopurina en el tratamiento de la enfermedad inflamatoria intestinal , 2002 .

[93]  J. Mate,et al.  [Questions and answers on the role of azathioprine and 6-mercaptopurine in the treatment of inflammatory bowel disease]. , 2002, Gastroenterologia y hepatologia.

[94]  A. Forbes,et al.  Review article: Immunosuppressants in distal ulcerative colitis. , 2002, Alimentary pharmacology & therapeutics.

[95]  O. Zmora,et al.  Immunosuppressants and operation in ulcerative colitis. , 2002, Journal of the American College of Surgeons.

[96]  G. Mantzaris,et al.  Oral azathioprine for steroid refractory severe ulcerative colitis , 2001, American Journal of Gastroenterology.

[97]  A. Sood,et al.  Role of azathioprine in severe ulcerative colitis: one-year, placebo-controlled, randomized trial. , 2000, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology.

[98]  R. Modigliani,et al.  Azathioprine or 6-mercaptopurine for inducing remission of Crohn's disease. , 2000, The Cochrane database of systematic reviews.

[99]  R. Baldassano,et al.  Experiences with 6-mercaptopurine and azathioprine therapy in pediatric patients with severe ulcerative colitis. , 1999, Journal of pediatric gastroenterology and nutrition.

[100]  M. A. Peppercom.  6-mercaptopurine for the management of ulcerative colitis: a concept whose time has come. , 1996, The American journal of gastroenterology.

[101]  J. Markowitz,et al.  Immunosuppressive therapy in pediatric inflammatory bowel disease: results of a survey of the North American Society for Pediatric Gastroenterology and Nutrition. Subcommittee on Immunosuppressive Use of the Pediatric IBD Collaborative Research Forum. , 1993, The American journal of gastroenterology.

[102]  B. Korelitz,et al.  The therapeutic efficacy of 6-mercaptopurine in refractory ulcerative colitis. , 1990, The American journal of gastroenterology.

[103]  V. Drozdov,et al.  [Effect of sulfasalizine with azathioprine on some immunologic indices in patients with nonspecific ulcerative colitis]. , 1970, Klinicheskaia meditsina.

[104]  Rudnev Gp,et al.  Glucocorticoid metabolism in the treatment of viral hepatitis , 1970 .