| Theme |
Therapeutic strategy for ulcerative colitis ; from standard to up-to-date |
| Title |
Appropriate usage of azathioprine/6-mercaptopurine for IBD patients |
| Author |
Makoto Naganuma |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Mamoru Watanabe |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| [ Summary ] |
6-Mercaptopurine/Azathioprine (6-MP/AZA) is effective for maintenance of remission in refractory ulcerative colitis (UC) patients. It is critical that we understand when and how to use 6-MP/AZA to obtain higher rates of response with these treatments. We describe the following (1) 6-MP/AZA should not be used to induce remission in severe UC patients, (2) steroid dependent patients, should be treated with 6-MP/AZA as soon as possible, while induction of remission may still be obtained, (3) 6-MP/AZA should be used when cyclosporine/tacrolimus is administered to maintain remission and to improve long-term prognoses for UC patients, (4) infliximab or surgical options should be considered for 6-MP/AZA refractory UC patients. |