The Efficacy And Safety Of Azathioprine In The Treatment Of Ulcerative Colitis

Objective To investigate the clinical characters of the patients with ulcerative colitis (UC), as well as the efficacy and safety of azathioprine used in UC patients.Methods Collecting the clinical data of the 101 patients with UC who admitted in Peking Union Medical College Hospital from 2007 to 2009, a retrospective analysis of clinical characters of them, as well as the efficacy and safety of azathioprine used in UC patients who were followed more than 3 months, were made.Results Among the 101 UC inpatients, the ratio between male and female is 1:0.94, and the average onset of disease is 35.7±13.7 years, with the average duration 80.2±60.4 months. The degree of the UC patients revealed mild(17.8%), moderate(35.6%) or severe(46.8%). In all cases, chronic persistent type(83.2%)dominated apparently, with 76.2% active.63.3% of the inpatients involved pancolitis. Extraintestinal manifestation accounted for 24.8%, while joint pain accounted for13.9%. Complication of UC was not common (7.9%).18.8% of patients were taking 50 to 75mg/d of azathioprine with average duration 14.0 (0.5-49) months. Complete remission was achieved in 46.2%, partial remission in 30.7% and failure to achieve remission in 23.1% of the UC patients. Side effects happened in 26.3% of the patients, including leucopenia(10.5%), abnormal liver test (10.5%) and headache (5.3%).10.5 percent of patients cannot tolerate AZA, while 10.5% were-combined with fungi infection with long-time use.Conclusion Azathioprine is a kind of relatively safe and tolerated immunosuppressive agents for UC patients and appears slightly less effective at a lower dosage (0.83mg/kg/d) compared with recommended dosage(2-2.5mg/kg/d) by Western countries. Adverse effects of azathioprine are common, but not severe. Fungi infection should be alerted when azathioprine is used for a long time.