P436 Efficacy and safety of azathioprine treatment in Asian patients with Ulcerative Colitis
R. Mao*1, Y.-f. Li2, B.-l. Chen1, Y. He1, Z.-r. Zeng1, M.-h. Chen1
1First Affiliated Hospital of Sun Yat-Sen University, Department of Gastroenterology, Guangzhou, China, 2Singapore General Hospital, Department of Internal Medicine, Singapore, Singapore
To evaluate the efficacy (clinical efficacy and mucosal healing) and safely of azathioprine (AZA) treatment in Asian patients with ulcerative colitis (UC).
85 patients with UC who were treated with AZA from 2003 to 2012 were reviewed. The indications for AZA use were as follows: (1) steroid dependent and steroid refractory disease; (2) AZA maintenance monotherapy for naive patients with severe disease; and (3) combination maintanence therapy (AZA + 5-ASA) .
In steroid refractory/dependent group, the cumulative rate of clinical remission at 2 and 4 weeks after AZA use was 37.3% and 72.1%, respectively. The cumulative rates of mucosal healing for maintenance treatment at 6, 12 and 24 months were 10.2%, 22.2% and 34.0%, respectively. Factors associatetd with relapse for AZA maintenance therapy were age less than 40 years at diagnosis (OR=2.346, 95%CI: 1.112-4.949, p=0.025) and dose less than 50mg/d (OR=2.708, 95%CI: 1.213-6.046, p=0.015). 34 (40%) patients experienced adverse effects and 26 (30.6%) patients stopped or temporarily withdrew the use of AZA. Factors associated with adverse effects of AZA use were age of diseae onset older than 40 years (OR=2.074, 95%CI: 1.051-4.095, p=0.036) and combination use of 5-ASA (OR=3.579, 95%CI: 1.598-8.015, p=0.002).
AZA is an effective treatment for UC including clinical efficacy and mucosal healing in Asian patients. However, the adverse effects should be cautioned during the use of AZA.