| Abstract | BACKGROUND: The role of azathioprine and methotrexate in inducing and maintaining remission in patients with ulcerative colitis is still controversial. AIM: To evaluate the efficacy and tolerability of these two drugs in a series of patients with steroid-dependent or steroid-resistant active ulcerative colitis. METHODS: Forty-two patients were treated with a daily dose of azathioprine (2 mg/kg) and, if intolerant or not responding, with methotrexate (12.5 mg/week intramuscularly), and their efficacy was established by clinical, endoscopic and histological examinations at 6 months. Patients achieving clinical remission continued with treatment and were followed up. RESULTS: Of the 42 patients on azathioprine, 10 experienced early side-effects requiring withdrawal from treatment, 22 (69%) achieved complete remission, six (19%) achieved improvement and four (12%) obtained no substantial benefit. Methotrexate, administered to eight patients intolerant to and two patients resistant to azathioprine, induced complete remission in six patients (60%) and improvement in four (40%). During follow-up, a larger number of patients on azathioprine relapsed in comparison with patients on methotrexate [16/28 (57%) vs. 2/10 (20%), respectively; P < 0.05]. Only minor side-effects were observed on both treatments. CONCLUSIONS: Azathioprine is effective in patients with steroid-dependent or steroid-resistant ulcerative colitis. Methotrexate seems to be a good alternative in patients intolerant to or not responding to azathioprine. |
| Authors | O A Paoluzi, R Pica, A Marcheggiano, P Crispino, F Iacopini, C Iannoni, M Rivera, P Paoluzi
(Affiliation: Department of Clinical Sciences, Gastroenterology Unit, La Sapienza University, Rome, Italy. paolo.paoluzi at uniroma1.it)
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| Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 16
Issue 10
Pg. 1751-9
(Oct 2002)
ISSN: 0269-2813 England |
| PMID | 12269968
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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| Chemical References |
- Anti-Inflammatory Agents
- Immunosuppressive Agents
- Azathioprine
- Prednisone
- Methotrexate
|
| Topics |
- Adult
- Aged
- Anti-Inflammatory Agents
(therapeutic use)
- Azathioprine
(adverse effects, therapeutic use)
- Colitis, Ulcerative
(drug therapy, pathology)
- Drug Administration Schedule
- Drug Resistance
- Female
- Follow-Up Studies
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Male
- Methotrexate
(adverse effects, therapeutic use)
- Middle Aged
- Prednisone
(therapeutic use)
- Remission Induction
- Single-Blind Method
- Treatment Outcome
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