P595 Azathioprine is effective and safe in inducing and maintaining deep remission in Crohn's disease
J. Tang*, X. Gao, M. Zhi, P. Hu
The Sixth Affiliated Hospital of Sun Yat-sen University, Department of Gastroenterology, Guangzhou, China
Deep remission, defined as clinical remission, biomarker remission and mucosal healing (MH), is a new treatment target and might be the only way to alter disease course in Crohn's disease (CD). This retrospective study examined whether azathioprine(AZA) could be an effective and safe agent in inducing and maintaining deep remission.
The clinical data of all CD patients were reviewed from 2012 to July 2013. The patients who initiated AZA treatment and were followed for 1 year with complete medical data were included. All the patients were induced remission by glucocorticoid or operation. AZA was prescribed at the same time with glucocorticoid or within 2 weeks after operation. Deep remission rate at year 1was analyzed.
Among 49 patients, 40 patients were induced by glucocorticoid and 9 patients received operation. The baseline characters were described as follow: high sensitive C-active protein (hs-CRP) 12.05 ± 4.04mg/l, PLT 360.65 ± 117.17 × 109/L, CDAI 220.05 ± 82.84, Simple Endoscopic Score for Crohn`s Disease (SES-CD) was 12.09 ± 6.29. 12 patients derived AZA associated side effects during follow-up, 10 of them stopped therapy. The major side effects occurred was bone marrow suppression (9/12). 39 of 49 patients completed 1 year therapy on AZA. The steroid free remission rate was 74.36% (29/39), clinical remission rate was 87.18% (34/39), muscle healing rate was 33.33%(13/39) and deep remission rate was 23.07% (9/39). At year 1, the serum biomarkers were declined to normal range: hs-CRP 5.79 ± 0.87mg/l mg/l, PLT 265.94 ± 15.39 × 109/L , CDAI was 102.97 ± 10.46, SES-CD was 4.97 ± 0.89. All the parameters were significantly improved compared with baseline(P<0.05).
Azathiopurine is not only effective in maintaining clinical remission, but also could induce deep remission in CD. Side effects should be carefully monitored during follow-up.