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Article: Low-dose azathioprine is effective in maintaining remission in steroid-dependent ulcerative colitis: results from a territory-wide Chinese population-based IBD registry

TitleLow-dose azathioprine is effective in maintaining remission in steroid-dependent ulcerative colitis: results from a territory-wide Chinese population-based IBD registry
Authors
Issue Date2016
PublisherSage Publications Ltd.. The Journal's web site is located at http://tag.sagepub.com
Citation
Therapeutic Advances in Gastroenterology, 2016, v. 9 n. 4, p. 449-456 How to Cite?
AbstractBACKGROUND: Whether low-dose azathioprine (AZA) is effective in maintaining remission in patients with steroid-dependent ulcerative colitis (UC) remains unclear. We assessed the efficacy and safety of low-dose AZA in a Chinese population with UC. METHODS: We identified steroid-dependent UC patients in clinical remission on AZA maintenance therapy from a territory-wide IBD Registry. Standard- and low-dose AZA were defined as at least 2 mg/kg/day and less than 2 mg/kg/day, respectively. Relapse rates were analyzed by Kaplan-Meier analysis and compared using log-rank test. RESULTS: Among 1226 UC patients, 128 (53% male, median duration on AZA 44 months) were included. Median maintenance AZA dose was 1.3 mg/kg/day. 97.7% of the patients were on concomitant oral 5-aminosalicylic acid. Cumulative relapse-free rates in patients on standard-dose and low-dose AZA were 71.2%, 52.8% and 45.2%, and 71.8%, 55.3% and 46.2% at 12, 24 and 36 months, respectively (p = 0.871). Relapse rate within 12 months was higher in patients who withdrew compared with those who maintained on AZA (52.6% versus 29.4%; p = 0.045). Mean corpuscular volume increased after AZA therapy in both of the low-dose [median (interquartile range, IQR): 88.2 (81.4-92.2) versus 95.1 (90.1-100.9) fl, p < 0.001] and standard-dose subgroups [median (IQR) 86.8 (76.9-89.9) versus 94.7 (85.9-99.7) fl, p < 0.001]. Leukopenia occurred in 21.1% of the patients. Patients on standard dose had a higher risk for leukopenia than those on low-dose AZA [odds ratio (OR) 3.9, 95% CI 1.9-8.2, p < 0.001]. CONCLUSIONS: In the Chinese population, low-dose AZA is effective for maintaining remission in steroid-dependent UC patients. Standard-dose AZA was associated with more than threefold increased risk of leukopenia.
Persistent Identifierhttp://hdl.handle.net/10722/232013
ISSN
2015 Impact Factor: 3.883
2015 SCImago Journal Rankings: 1.372
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorShi, HY-
dc.contributor.authorChan, FKL-
dc.contributor.authorLeung, WK-
dc.contributor.authorLi, MKK-
dc.contributor.authorLeung, CM-
dc.contributor.authorSze, SF-
dc.contributor.authorChing, JY-
dc.contributor.authorLo, FH-
dc.contributor.authorTsang, SW-
dc.contributor.authorShan, EHS-
dc.contributor.authorMak, LY-
dc.contributor.authorLam, BCY-
dc.contributor.authorHui, WH-
dc.contributor.authorChow, WH-
dc.contributor.authorWong, MTL-
dc.contributor.authorHung, FNI-
dc.contributor.authorHui, YT-
dc.contributor.authorChan, YK-
dc.contributor.authorChan, KH-
dc.contributor.authorLoo, CK-
dc.contributor.authorNg, CKM-
dc.contributor.authorLao, WC-
dc.contributor.authorHarbord, M-
dc.contributor.authorWu, JCY-
dc.contributor.authorSung, JJY-
dc.contributor.authorNg, SC-
dc.date.accessioned2016-09-20T05:26:59Z-
dc.date.available2016-09-20T05:26:59Z-
dc.date.issued2016-
dc.identifier.citationTherapeutic Advances in Gastroenterology, 2016, v. 9 n. 4, p. 449-456-
dc.identifier.issn1756-283X-
dc.identifier.urihttp://hdl.handle.net/10722/232013-
dc.description.abstractBACKGROUND: Whether low-dose azathioprine (AZA) is effective in maintaining remission in patients with steroid-dependent ulcerative colitis (UC) remains unclear. We assessed the efficacy and safety of low-dose AZA in a Chinese population with UC. METHODS: We identified steroid-dependent UC patients in clinical remission on AZA maintenance therapy from a territory-wide IBD Registry. Standard- and low-dose AZA were defined as at least 2 mg/kg/day and less than 2 mg/kg/day, respectively. Relapse rates were analyzed by Kaplan-Meier analysis and compared using log-rank test. RESULTS: Among 1226 UC patients, 128 (53% male, median duration on AZA 44 months) were included. Median maintenance AZA dose was 1.3 mg/kg/day. 97.7% of the patients were on concomitant oral 5-aminosalicylic acid. Cumulative relapse-free rates in patients on standard-dose and low-dose AZA were 71.2%, 52.8% and 45.2%, and 71.8%, 55.3% and 46.2% at 12, 24 and 36 months, respectively (p = 0.871). Relapse rate within 12 months was higher in patients who withdrew compared with those who maintained on AZA (52.6% versus 29.4%; p = 0.045). Mean corpuscular volume increased after AZA therapy in both of the low-dose [median (interquartile range, IQR): 88.2 (81.4-92.2) versus 95.1 (90.1-100.9) fl, p < 0.001] and standard-dose subgroups [median (IQR) 86.8 (76.9-89.9) versus 94.7 (85.9-99.7) fl, p < 0.001]. Leukopenia occurred in 21.1% of the patients. Patients on standard dose had a higher risk for leukopenia than those on low-dose AZA [odds ratio (OR) 3.9, 95% CI 1.9-8.2, p < 0.001]. CONCLUSIONS: In the Chinese population, low-dose AZA is effective for maintaining remission in steroid-dependent UC patients. Standard-dose AZA was associated with more than threefold increased risk of leukopenia.-
dc.languageeng-
dc.publisherSage Publications Ltd.. The Journal's web site is located at http://tag.sagepub.com-
dc.relation.ispartofTherapeutic Advances in Gastroenterology-
dc.rightsTherapeutic Advances in Gastroenterology. Copyright © Sage Publications Ltd..-
dc.titleLow-dose azathioprine is effective in maintaining remission in steroid-dependent ulcerative colitis: results from a territory-wide Chinese population-based IBD registry-
dc.typeArticle-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.emailHung, FNI: ivanhung@hkucc.hku.hk-
dc.identifier.authorityLeung, WK=rp01479-
dc.identifier.authorityHung, FNI=rp00508-
dc.identifier.doi10.1177/1756283X16643509-
dc.identifier.pmcidPMC4913336-
dc.identifier.hkuros263768-
dc.identifier.volume9-
dc.identifier.issue4-
dc.identifier.spage449-
dc.identifier.epage456-
dc.publisher.placeUnited Kingdom-

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