ArticleJGH open : an open access journal of gastroenterology and hepatology2023
Long-term safety and effectiveness of azathioprine in the management of inflammatory bowel disease: A real-world experience.
Article in JGH open : an open access journal of gastroenterology and hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Azathioprine Increases the Risk of Non-Melanoma Skin Cancer Among Organ Transplant Recipients; an Updated Systematic Review and Meta-Analysis.Cancer reports (Hoboken, N.J.) · 2026Pooled it
- Disability among Palestinian patients with inflammatory bowel disease: evaluation using the IBD Disk and identification of associated factors.Crohn's & colitis 360 · 2026Article
- Azathioprine Toxicity in Patients With Myasthenia Gravis: A Single Center Experience.Muscle & nerve · 2026Article
- Drug-induced neutropenia: A comprehensive pharmacovigilance study of the FAERS database.Medicine · 2026Article
- Colon-targeted microbiota-modulating nanoparticles amplify azathioprine efficacy via gut microbiota axis remodeling in inflammatory bowel disease.Journal of nanobiotechnology · 2026Article
- Adverse Events Related to Azathioprine Use in Patients With Inflammatory Bowel Disease: A Real-World Cohort Study.Gastroenterology research and practice · 2026Article
- Article
- Development and Application of an LC-MS/MS Method for Simultaneous Quantification of Azathioprine and Its Metabolites: Pharmacokinetic and Microbial Metabolism Study of a Colon-Targeted Nanoparticle.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Relapse Rates and Predictors Following Azathioprine Withdrawal in Inflammatory Bowel Disease: A Systematic Review, Meta-Analysis, and Meta-Regression.Journal of clinical medicine · 2025Review
- Pathophysiological Links Between Inflammatory Bowel Disease and Cardiovascular Disease: The Role of Dysbiosis and Emerging Biomarkers.Biomedicines · 2025Review
- Contemporary and prospective use of azathioprine (AZA) in viral, rheumatic, and dermatological disorders: a review of pharmacogenomic and nanotechnology applications.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Inflammatory bowel disease in south Asia: a scoping review.The lancet. Gastroenterology & hepatology · 2025Article
- Laboratory Tests in Inflammatory Bowel Disease: An Evidence-Based Approach to Daily Practice.Biomedicines · 2025Review
- Article
- Ulcerative Colitis: Advances in Pathogenesis, Biomarkers, and Therapeutic Strategies.Pharmacogenomics and personalized medicine · 2025Review
- Perspectives in clinical research on Azathioprine for steroid-dependent ulcerative colitis.Frontiers in medicine · 2025Article
- Treatment of rheumatoid arthritis-associated interstitial lung disease: An appraisal of the 2023 ACR/CHEST guideline.Current treatment options in rheumatology · 2024Article
- Antioxidant Therapy in Inflammatory Bowel Diseases: How Far Have We Come and How Close Are We?Antioxidants (Basel, Switzerland) · 2024Review
- Effects of acupuncture and moxibustion on ulcerative colitis: An overview of systematic reviews.Heliyon · 2024Article
- Uphill battle: Innovation of thiopurine therapy in global inflammatory bowel disease care.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aim: Azathioprine (AZA) forms the cornerstone for maintenance of sustained remission in inflammatory bowel disease (IBD). There is apprehension regarding the long-term effectiveness and safety of AZA in IBD. We present our experience with AZA use and outcomes in a cohort of IBD patients followed up over a long period of time. Methods: Records of 507 IBD patients under treatment at a single, tertiary care center in south India between 2013 and 2022 were evaluated retrospectively. Long-term compliance, tolerance, clinical outcome at the point of last follow-up, type and duration to the onset of adverse events, and subsequent amendment to treatment with regard to AZA were analyzed. Results: Of 507 patients with IBD, 320 patients (207 Crohn's disease [CD], 113 ulcerative colitis [UC]) who received AZA were included. The median follow-up was 41 months (interquartile range 15.5-77.5). Total duration of exposure was 1359 patient-years with median usage of 33 months. Of the patients, 26.9% received AZA for >5 years. Mean initiation and maximum doses of AZA were 0.97 and 1.72 mg/kg/day. Among the participants, 20.6% experienced side effects, including myelotoxicity (7.2%) and gastrointestinal intolerance (5.6%). Six patients developed malignancy. Among the side effects, 39.4% of side effects were dose-dependent. Among the patients, 38.1% had relapses requiring pulse corticosteroid therapy, and 16.2% had more than one relapse after commencement of AZA. AZA was continued till the last follow-up in 76.5%. Among the patients, 49.7% (UC 51.3, CD 48.8) attained durable remission without biologics, and 5.3% continued to have active disease. Conclusion: AZA is safe and effective in the long-term in IBD. Effectiveness, tolerance, and compliance with AZA are well sustained beyond 5 years of usage and comparable between UC and CD.
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