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azathioprine crohn

Christian Mottet, Alain M Schoepfer, Pascal Juillerat, Jacques Cosnes, Florian Froehlich, Vera Kessler-Brondolo, Frank Seibold, Gerhard Rogler, Stephan R Vavricka, Pierre Michetti
The relevance of azathioprine and 6-mercaptopurine therapy in inflammatory bowel disease, Crohn's disease, and ulcerative colitis, has been challenged in recent publications. In this article, a panel of experts gives advice, based on the relevant literature, on indications and practical use of azathioprine/6-mercaptopurine, prevention, and management of drug adverse reactions and special situations such as vaccination, pregnancy, and lactation.
November 2016: Inflammatory Bowel Diseases
Carlos García Encinas, Patricia Guzmán Rojas, Jorge Espinoza-Rios, Víctor Aguilar Sánchez, Eduar Bravo Paredes, Andrea Portocarrero, Jorge Huerta-Mercado, Jaime Cáceres Pizarro, Alejandro Bussalleu Rivera
Inflammatory bowel disease is associated with extraintestinal manifestations. Among these manifestations is the venous tromboembolism which presents a risk three times more than that presented in general population. We report the case of a 61-year-old male with a history of abdominal pain, chronic diarrhea and fever, with leukocytosis, and fecal samples containing leukocytes, partial ileal stenosis with multiple ulcers in the enteroscopy, with histologic findings compatible with Crohn's disease. The patient has a good outcome with prednisone and maintenence azathioprine, presenting at the fifth month deep venous thrombosis of both lower extremities that resolvewith anticoagulation treatment...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
Marianne Kiszka-Kanowitz, Klaus Theede, Anette Mertz-Nielsen
BACKGROUND: Treating inflammatory bowel diseases (IBD) using thiopurines is effective; however, a high rate of adverse effects and lack of efficacy limit its use. Retrospective studies have suggested that treatment with low-dose thiopurines in combination with allopurinol is associated with higher remission rates and lower incidence of adverse events. AIM: To compare the rates of clinical remission and the rates of adverse events in IBD patients treated with either standard treatment with azathioprine or low-dose azathioprine in combination with allopurinol...
December 2016: Scandinavian Journal of Gastroenterology
Christopher Alexakis, Kristiana Gordon, Russell Mellor, Heung Chong, Peter Mortimer, Richard Pollok
BACKGROUND AND AIMS: Ano-genital granulomatosis is a rare chronic granulomatous condition of the skin that causes lymphoedema of the external genitalia. There is a reported association with Crohn's disease. Mechanisms of disease, and optimal methods of treatment are poorly understood. METHODS: A retrospective case note review of 25 male patients with ano-genital granulomatosis presenting with genital lymphoedema was performed to determine the clinical and histopathological features of this condition and its relationship to intestinal Crohn's disease...
September 28, 2016: Journal of Crohn's & Colitis
L Stratton, G R Caddy
Patients with Crohn's disease often require the use of immunosuppressant drugs to control disease activity. Such medication includes steroids, azathioprine, and biologic therapy. These suppress the immune response, and the patient is more susceptible to infection. We present a case of a 69-year-old gentleman with a history of Crohn's colitis who had ongoing symptoms of diarrhoea in spite of standard treatment. Biologic therapy was considered to be the next step, and screening for infection was undertaken prior to use...
2016: Case Reports in Gastrointestinal Medicine
Carmen-Monica Preda, Larisa Elena Fulger, Lucian Negreanu, Mircea Manuc, Irina Sandra, Mircea-Mihai Diculescu
AIM: Perform a comparison between adalimumab (ADA) and infliximab (IFX) in treating post-operative recurrence of Crohn's disease (a comparative analysis of efficacy and safety). METHODS: From the 267 patients treated with Adalimumab or Infliximab between January 2005 and June 2014 in Romania, 44 received anti- TNF (tumor necrosis factor) therapy for prevention of post-operative recurrence. A comparison between patients treated with IFX and ADA was made with the Chi- square and t- student test, with the aid of the statistical program Mini Tab 17...
October 2016: Revista Española de Enfermedades Digestivas
Edward L Barnes, Alison Goldin, Rachel W Winter, Emily Collins, Bonnie Cao, Madeline Carrellas, Anne Marie Crowell, Joshua R Korzenik
BACKGROUND: The benefits of combination therapy with infliximab and azathioprine have been demonstrated in clinical trials of patients with ulcerative colitis (UC) and Crohn's disease (CD). Concerns remain regarding the ideal duration and benefits of adding therapies in a sequential manner. AIMS: We aim to compare long-term outcomes among patients with inflammatory bowel disease (IBD) treated with sequentially added combination therapy or monotherapy strategies ...
November 2016: Digestive Diseases and Sciences
Renáta Bor, Klaudia Farkas, Anita Bálint, Mónika Szűcs, Szabolcs Ábrahám, Ágnes Milassin, Mariann Rutka, Ferenc Nagy, Péter Milassin, Zoltán Szepes, Tamás Molnár
OBJECTIVES: Magnetic resonance imaging (MRI) and transrectal sonography are the two accepted imaging modalities for evaluation of perianal fistulas and abscesses. Transperineal sonography is a new technique that is easy to learn and can be performed at any time. The purpose of this study was to prospectively compare the diagnostic accuracy of MRI, transrectal sonography, and transperineal sonography with surgical findings in patients with perianal Crohn disease. METHODS: All patients with perianal Crohn disease underwent MRI, transrectal sonography, and transperineal sonography within a few days before surgery...
September 14, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Huiqin Hu, Xinying Wang, Side Liu
BACKGROUND: Thalidomide has been successful use in patients with refractory Crohn disease (CD) in recent years. METHODS: We collected the data of a postoperative CD patient who was prescribed thalidomide to induce remission and reviewed the relevant literatures. RESULTS: A 51-year-old female was diagnosed as CD after an urgent terminal intestinal resection and presented endoscopic recurrence despite the prophylactic treatment with azathioprine (AZA)...
September 2016: Medicine (Baltimore)
Takayuki Matsumoto, Satoshi Motoya, Kenji Watanabe, Tadakazu Hisamatsu, Hiroshi Nakase, Naoki Yoshimura, Tetsuya Ishida, Shingo Kato, Tomoo Nakagawa, Motohiro Esaki, Masakazu Nagahori, Toshiyuki Matsui, Yuji Naito, Takanori Kanai, Yasuo Suzuki, Masanori Nojima, Mamoru Watanabe, Toshifumi Hibi, Diamond Study Group
BACKGROUND AND AIMS: The efficacy of azathioprine for Crohn's disease under adalimumab treatment remains obscure. METHODS: In an open-labeled prospective study, we evaluated the efficacy of adalimumab with and without azathioprine in patients with active Crohn's disease, who were naïve to biologics and thiopurines. The patients were randomly assigned to subcutaneous administration of adalimumab (monotherapy group) or to exactly the same schedule of adalimumab with azathioprine (25-100 mg daily) (combination group) for 52 weeks...
August 26, 2016: Journal of Crohn's & Colitis
Donata Lissner, Britta Siegmund
Historically, in the 1950s, the introduction of simple, old-fashioned steroids resulted in a significant drop in mortality and hence offered for the first time a real therapeutic option for patients with inflammatory bowel disease. However, as we are all aware of, steroids are no option for maintenance of remission. This review will provide an overview of the available data on the current role of azathioprine in the therapy of Crohn's disease. Based on several controlled trials, the place of azathioprine for maintenance of remission is indisputable...
2016: Digestive Diseases
Jonathan R Dillman, Ethan A Smith, Ramon Sanchez, Jeremy Adler, Soudabeh Fazeli, Bin Zhang, Matthew S Davenport
OBJECTIVE: The purpose of this study was to determine prospectively whether bowel wall apparent diffusion coefficient (ADC) measurements can be used to monitor treatment response to infliximab therapy in the setting of pediatric small-bowel Crohn disease. SUBJECTS AND METHODS: Twenty-eight pediatric subjects with newly diagnosed biopsy-proven Crohn disease of the distal or terminal ileum treated with infliximab were enrolled. Subjects underwent MR enterography at baseline, 1 month after therapy, and 6 months after therapy...
November 2016: AJR. American Journal of Roentgenology
Katarzyna Klimczak, Liliana Łykowska-Szuber, Iwona Krela-Kaźmierczak, Piotr Eder, Aleksandra Szymczak, Kamila Stawczyk-Eder, Krzysztof Linke
M ethotrexate (MTX) as an immunomodulatory drug has numerous applications in autoimmune diseases. Autoimmune patomechanism is one of the factors responsible for development of inflammatory bowel diseases (IBD). MTX is an alternative therapy in the treatment of IBD. Over the past several years clinical trials has confirmed the efficacy of MTX in the treatment of Crohn's disease (CD). Data concerning use of MTX in ulcerative colitis (UC) are not as numerous as in the CD. Currently, MTX is recommended for the induction treatment and maintenance therapy in CD patients, especially in steroid-dependent patients, disease refractory to corticosteroids, no improvement after treatment with azathioprine and 6-mercaptopurine, or in case of intolerance to these drugs...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Marianne R Spalinger, Jonas Zeitz, Luc Biedermann, Jean-Benoit Rossel, Michael C Sulz, Pascal Frei, Sylvie Scharl, Stephan R Vavricka, Michael Fried, Gerhard Rogler, Michael Scharl
BACKGROUND: Protein tyrosine phosphatase non-receptor type 22 (PTPN22) plays an important role in immune cell function and intestinal homeostasis. The single nucleotide polymorphism (SNP) rs2476601 within the PTPN22 gene locus results in aberrant function of PTPN22 protein and protects from Crohn's disease (CD). Here, we investigated associations of PTPN22 SNP rs2476601 in inflammatory bowel disease (IBD) patients in the Swiss IBD Cohort Study (SIBDCS). METHODS: 2'028 SIBDCS patients (1173 CD and 855 ulcerative colitis (UC) patients) were included...
2016: PloS One
Amine Benmassaoud, Xuanqian Xie, Motaz AlYafi, Yves Theoret, Alain Bitton, Waqqas Afif, Talat Bessissow
Background and Aims. Thiopurines are used in the treatment of Crohn's disease (CD) and thiopurine S-methyltransferase (TPMT) activity can guide thiopurine dosing to avoid adverse events. This retrospective study evaluated the safety and efficacy of starting thiopurines at low dose versus full dose in patients with CD and normal TPMT. Methods. This was a single center retrospective study including adult CD patients with normal TPMT levels (≥25 nmol/hr/g Hgb) who were followed for 1 year. Patients started at full dose of azathioprine (2-2...
2016: Canadian Journal of Gastroenterology & Hepatology
Timothy Ross Elliott, Charles Miller, Finlay A Macrae
Patients with inflammatory bowel disease (IBD), particularly those on immunosuppressive medications, suffer a high incidence of, and worse clinical outcomes relating to, herpes zoster (HZ) reactivation. We report on the presentation and management of a patient with Crohn's disease who developed severe perianal HZ after starting azathioprine and oral budesonide treatment. The zoster vaccine may prevent such zoster reactivation in patients with IBD. The zoster vaccine is effective in decreasing the risk of HZ in older adults but its role in younger adults and those with IBD has not been tested prospectively...
2016: BMJ Case Reports
Valérie Heron, Kyle Joshua Fortinsky, Gillian Spiegle, Nir Hilzenrat, Andrew Szilagyi
Hepatocellular carcinoma rarely occurs in patients without underlying cirrhosis or liver disease. While inflammatory bowel disease has been linked to certain forms of liver disease, hepatocellular carcinoma is exceedingly rare in these patients. We report the twelfth case of hepatocellular carcinoma in a patient with Crohn's disease. The patient is a 61-year-old with longstanding Crohn's disease who was treated with azathioprine and was found to have elevated liver enzymes and a new 3-cm liver mass on ultrasound...
January 2016: Case Reports in Gastroenterology
Gionata Fiorino, Silvio Danese
No abstract text is available yet for this article.
July 7, 2016: Journal of Crohn's & Colitis
Anne Veie Plauborg, Anne Vinkel Hansen, Ester Garne
BACKGROUND: The aim of this study was to describe prescription patterns for azathioprine and corticosteroids for pregnant women with inflammatory bowel diseases (IBD) before, during, and after pregnancy and to describe pregnancy outcomes. METHODS: A cohort composed of all singleton pregnancies in Danish registries from 1996 to 2009 was divided by maternal IBD status: Crohn's disease (CD, n = 827), ulcerative colitis (UC, N = 1361), or no IBD diagnosis (background population, n = 814,231)...
June 2016: Birth Defects Research. Part A, Clinical and Molecular Teratology
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