Premium
Drug interaction between infliximab and azathioprine in patients with Crohn's disease
Author(s) -
Roblin X.,
SerreDebeauvais F.,
Phelip J.M.,
Bessard G.,
Bonaz B.
Publication year - 2003
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.1365-2036.2003.01778.x
Subject(s) - infliximab , medicine , azathioprine , methotrexate , crohn's disease , gastroenterology , prospective cohort study , rheumatoid arthritis , surgery , disease
Summary Background : A drug interaction has been observed between infliximab and methotrexate in rheumatoid arthritis. Aim : To look for an interaction between infliximab and azathioprine in Crohn's disease patients using the active metabolites of azathioprine: 6‐tioguanine nucleotides. Methods : Patients receiving azathioprine who required infliximab for ileo‐colonic or ano‐perineal Crohn's disease were recruited prospectively. 6‐tioguanine nucleotide levels were evaluated before infusion, within 1–3 weeks after the first infusion and 3 months after the first infusion. The clinical outcome was evaluated by the Harvey–Bradshaw index or the closure of ano‐perineal fistulas. Results : Thirty‐two patients were included (17 received one infusion and 15 received three infusions). The mean 6‐tioguanine nucleotide level was comparable before and 3 months after the first infusion, but a significant increase was observed within 1–3 weeks after the first infusion ( P < 0.001). In parallel, a significant decrease in leucocyte count and increase in mean corpuscular volume were observed; these modifications were normalized 3 months after infusion. An increase in 6‐tioguanine nucleotide level of greater than 400 pmol/8 × 10 8 erythrocytes was strongly related to good tolerance and a favourable response to infliximab, with a predictive value of 100%. Conclusions : This prospective study provides evidence for a drug interaction between azathioprine and infliximab.