Azathioprine for refractory ulcerative proctitis: A retrospective multicenter studyReport as inadecuate




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1 CHU Pontchaillou Rennes 2 Foie, métabolismes et cancer 3 CIC - Centre d-Investigation Clinique Rennes 4 Service d-hépato-gastroentérologie 5 CHU de Saint-Etienne - Centre Hospitalier Universitaire de Saint-Etienne 6 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux 7 Service des Maladies de l-Appareil Digestif

Abstract : BACKGROUND: Efficacy of azathioprine AZA in refractory ulcerative proctitis UP is unknown.METHODS: All patients treated with AZA for refractory UP in three referral centers between 2002 and 2012 were included. -Treatment success- in the long-term was defined as the absence of colectomy during follow-up, no need for anti-TNF during follow-up, no ongoing systemic steroids use, no adverse event leading to AZA withdrawal, and clinically quiescent disease at last follow-up.RESULTS: Of the 1279 adult patients with ulcerative colitis, 25 patients were treated with AZA for refractory UP median disease duration 4.9 years. Of these, 4 had no short-term clinical assessment. Of the remaining 21, 4 were primary non responders to AZA, 7 discontinued AZA for adverse events and 10 showed clinical improvement. At the long-term assessment at last follow up after a median of 46 months, 5 patients had treatment success and were still on AZA treatment, the remaining 20 were treatment failures. Of these, 5 discontinued AZA for adverse events and 15 were treated with infliximab clinical response in 11 patients, primary non-response in one patient, and 3 underwent colectomy.CONCLUSION: AZA may be efficacious in maintaining clinical response in one-fifth of patients with refractory UP in a real-life setting.

Keywords : Azathioprine Proctitis Ulcerative colitis





Author: Anne-Laure Mallet - Guillaume Bouguen - Guillaume Conroy - Xavier Roblin - Jean-Bernard Delobel - Jean-François Bretagne - Laure

Source: https://hal.archives-ouvertes.fr/



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