COMMENTARY
Crohn's disease
Is thiopurine therapy in ulcerative colitis as effective as in Crohn’s disease?
1 Imperial College, Hammersmith Hospital, London, UK
2 Hammersmith Hospital, London, UK
Correspondence to:
Correspondence to:
Professor S Ghosh
Imperial College London, Hammersmith Hospital, Ducane Rd, London W12 0NN, UK; s.ghosh@imperial.ac.uk
There is evidence in support of the use of azathioprine in steroid dependent ulcerative colitis patients, confirming the steroid sparing effect of azathioprine
Keywords: steroid dependent ulcerative colitis; azathioprine; 5-aminosalicylic acid
| The first 150 words of the full text of this article appear below. |
The use of azathioprine or 6-mercaptopurine for maintaining remission in Crohn’s disease patients who are steroid dependent or resistant is unequivocally supported by evidence from randomised controlled clinical trials. The same, however, cannot be said for the use of immunomodulator therapy in ulcerative colitis (UC). Trials are scanty, small in size, conflicting in results, and clinical practice is dominated by support from low quality evidence from open series reports. In addition, outcome measures used in different trials vary considerably, and the tools used to assess clinical disease activity are numerous and diverse.
In the first randomised controlled trial, conducted way back in 1974 by Jewell and Truelove,1 a two by three stratification was used. Inpatients or outpatients with active UC were stratified into first attack, short history (less than five years), and long history (more than five years). The acute episode was treated with corticosteroids, either 20 mg
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Gut 2006 55: 47-53.[Abstract] [Full Text] [PDF]
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