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Article Dans Une Revue Digestive and Liver Disease Année : 2017

Azathioprine for refractory ulcerative proctitis: A retrospective multicenter study

Résumé

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.
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Dates et versions

hal-01483854 , version 1 (22-05-2017)

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Anne-Laure Mallet, Guillaume Bouguen, Guillaume Conroy, Xavier Roblin, Jean-Bernard Delobel, et al.. Azathioprine for refractory ulcerative proctitis: A retrospective multicenter study. Digestive and Liver Disease, 2017, 49 (3), pp.280-285. ⟨10.1016/j.dld.2016.12.001⟩. ⟨hal-01483854⟩
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