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Azathioprine in paediatric inflammatory bowel disease: an Italian multicentre survey
Author(s) -
Barabino A.,
Torrente F.,
Ventura A.,
Cucchiara S.,
Castro M.,
Barbera C.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2002.01269.x
Subject(s) - azathioprine , medicine , discontinuation , inflammatory bowel disease , gastroenterology , population , corticosteroid , surgery , disease , environmental health
Summary Aim : To assess the efficacy and safety of azathioprine in a paediatric population with inflammatory bowel disease. Patients and methods : One hundred and twenty‐three Italian children treated with azathioprine were studied retrospectively. The treatment duration and causes of its discontinuation, side‐effects and variation in corticosteroid dose were assessed. Results : The mean age at inflammatory bowel disease diagnosis was 9.8 ± 3.6 years, and at the start of azathioprine therapy 11.8 ± 4.3 years. The mean duration of treatment was 19 ± 16 months. Fifty patients (41%) stopped treatment due to surgery (12%), prolonged remission (11%), non‐response (7%), severe side‐effects (7%) and poor compliance (3%). Of the 73 patients (59%) remaining on azathioprine, 11 had never been treated with corticosteroids, 27 were able to stop them and 35 were still on a very low daily dose (91% < 0.3 mg/kg). The difference in the daily corticosteroid dose between the beginning of azathioprine treatment (1 ± 0.6 mg/kg) and the conclusion of the study (0.18 ± 0.16 mg/kg) was statistically significant . Side‐effects were recorded in 48 of the 123 patients (39%), but only eight required discontinuation of azathioprine. Conclusions : Azathioprine was efficacious in 70% of patients, but ineffective in 20% and induced severe toxicity in 7%. Corticosteroids were stopped or markedly reduced in 62% of patients, but they were never given in 9%.