TITLE

Randomised controlled trial of azathioprine and 5-aminosalicylic acid for treatment of steroid dependent ulcerative colitis

AUTHOR(S)
Ardizzone, S.; Maconi, G.; Russo, A.; Imbesi, V.; Colombo, E.; Porro, G. Bianchi
PUB. DATE
January 2006
SOURCE
Gut;Jan2006, Vol. 55 Issue 1, p47
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background and aim: There are limited evidence based data concerning the use of azathioprine in ulcerative colitis. We aimed to compare the efficacy of azathioprine and oral 5-aminosalicylic acid in inducing remission of steroid dependent ulcerative colitis. Methods: Seventy two patients with steroid dependent ulcerative colitis were admitted to this investigator-blind study. Steroid dependence was defined as a requirement for steroid therapy ⩾1 0 mg/day during the preceding six months, with at least two attempts to discontinue the medication. The disease had to be clinically and endoscopically active at study entry, and all patients were taking systemic prednisolone (40 mg/day). Patients were randomised to receive azathioprine 2 mg/kg/day or oral 5-aminosalicylic acid 3.2 g/day, for a six month follow up period. The outcome of the treatment was defined as (1) success, indicating induction of clinical and endoscopic remission and steroid discontinuation, or (2) failure, indicating the absence of clinical and endoscopic remission and therefore the need for at least one further cycle of systemic s;eroids to control symptoms, apart from the initial one, or colectomy. Results: Significantly more patients in the azathioprine than in the 5-aminosalicylic acid group had clinical and endoscopic remission, and discontinued steroid therapy, both in the intention to treat (azathioprine v 5-aminosalicylic acid: 19/36 patients (53%) v 7/36 (21 %); odds ratio (OR) 4.78 (95% confidence interval (CI) 1 .57-14.5)) and per protocol (azathioprine v 5-aminosalicylic acid: 19/33 patients (58%) v 7/34 (21%); OR 5.26 (95% Cl 1.59-18.1)) analysis. Conclusions: Azathioprine is significantly more effective than 5-aminosalicylic acid in inducing clinical and endoscopic remission and avoiding steroid requirement in the treatment of steroid dependent ulcerative colitis.
ACCESSION #
19623582

 

Related Articles

  • Minilaparoscopy-assisted natural orifice total colectomy: technical report of a minilaparoscopy-assisted transrectal resection. Lacy, Antonio; Saavedra-Perez, David; Bravo, Raquel; Adelsdorfer, Cedric; Aceituno, Montserrat; Balust, Jaume // Surgical Endoscopy;Jul2012, Vol. 26 Issue 7, p2080 

    Background: Experimental experience and the technological evolution of minimally invasive surgical devices have allowed initial reports describing the clinical applicability of natural orifice translumenal endoscopic surgery (NOTES). Colorectal resections are an interesting target for the NOTES...

  • Is thiopurine therapy in ulcerative colitis as effective as in Crohn's disease? Ghosh, S.; Chaudhary, R.; Carpani, M.; Playford, R. J. // Gut;Jan2006, Vol. 55 Issue 1, p6 

    The article focuses on the question of effectiveness of thiopurine therapy in curing ulcerative colitis (UC). Thiopurine therapy is effective in curing Crohn's disease. But whether it is effective in curing UC or not, is the question of concern. Clinical trials of azathioprine have shown that it...

  • Steroid-Refractory Severe Ulcerative Colitis. Moss, Alan C.; Peppercorn, Mark A. // Drugs;2008, Vol. 68 Issue 9, p1157 

    Approximately 15% of patients with ulcerative colitis will experience a severe episode requiring hospitalization. Although intravenous corticosteroids are the current first-line therapy for these patients, about 30% of patients do not respond to corticosteroids and require either an alternative...

  • Long-Term Colectomy Rate After Intensive Intravenous Corticosteroid Therapy for Ulcerative Colitis Prior to the Immunosuppressive Treatment Era. Gustavsson, Anders; Halfvarson, Jonas; Magnuson, Anders; Sandberg-Gertzén, Hanna; Tysk, Curt; Järnerot, Gunnar // American Journal of Gastroenterology;Nov2007, Vol. 102 Issue 11, p2513 

    OBJECTIVES: Corticosteroids are a cornerstone in the treatment of a severe attack of ulcerative colitis (UC). The long-term prognosis in this patient group is not well described. We studied the long-term colectomy and relapse rates in patients given intensive intravenous corticosteroid treatment...

  • Efficacy of ecabet sodium enema on steroid resistant or steroid dependent ulcerative colitis. Iizuka, M.; Itou, H.; Konno, S.; Shirasaka, T.; Horie, Y.; Shindo, K.; Watanabe, S. // Gut;Oct2006, Vol. 55 Issue 10, p1523 

    The article presents a letter entitled "Efficacy of ecabet sodium enema on steroid resistant or steroid dependent ulcerative colitis" published within the issue. Ecabet sodium is a 12-sulfodehydroabietic acid monosodium salt commonly used for the treatment of gastritis and gastric ulcer. In a...

  • Clinical trial: probiotic treatment of acute distal ulcerative colitis with rectally administered Escherichia coli Nissle 1917 (EcN). Matthes, Harald; Krummenerl, Thomas; Giensch, Manfred; Wolff, Corinna; Schulze, Jürgen // BMC Complementary & Alternative Medicine;2010, Vol. 10, p13 

    Background: Probiotics are effective in inflammatory bowel diseases. Clinical effectiveness and dose dependency of E. coli Nissle (EcN) enemas were investigated in ulcerative colitis (UC). Methods: In a double-blind study, 90 patients with moderate distal activity in UC were randomly assigned to...

  • The management of dysplasia associated with ulcerative colitis: colectomy versus continued surveillance. Friedlich, Martin S.; Guindi, Maha; Stern, Hartley S. // Canadian Journal of Surgery;Jun2004, Vol. 47 Issue 3, p212 

    The article focuses on the management of dysplasia associated with ulcerative colitis (UC). Colectomy versus continued surveillance in patients with longstanding UC is a challenging decision. Several factors must be considered. Often such patients have quiescent disease, making the prospect of...

  • COLECTOMY DURING ACUTE PHASE OF CHRONIC ULCERATIVE COLITIS. Schroeder, Morrison // American Journal of Gastroenterology;Oct1956, Vol. 26 Issue 4, p443 

    Presents several cases of patients diagnosed with ulcerative colitis in the U.S. Use of colectomy in managing the acute phase of the disease; Causes of death in acute fulminating ulcerative colitis; Risk factors of the disease.

  • DISCUSSION.  // American Journal of Gastroenterology;Oct1956, Vol. 26 Issue 4, p447 

    Discusses results obtained from the surgical treatment of ulcerative colitis in the U.S. Details on the incidence of cancer in retained colons in patients not undergoing colectomy for ulcerative colitis; Percentage of patients treated medically for the disease; Accounts on the comparative...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics