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Azathioprine for refractory ulcerative proctitis: A retrospective multicenter study

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.
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Submitted on : Monday, May 22, 2017 - 9:32:48 AM
Last modification on : Tuesday, October 13, 2020 - 10:46:50 AM
Long-term archiving on: : Wednesday, August 23, 2017 - 2:32:13 PM

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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, WB Saunders, 2017, 49 (3), pp.280-285. ⟨10.1016/j.dld.2016.12.001⟩. ⟨hal-01483854⟩

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