Mercaptopurine immunosuppressing drugs Management of Crohn's disease

azathioprine, shown here in tablet form, first line steroid-sparing immunosuppressant

azathioprine , 6-mercaptopurine (6-mp) commonly used immunosuppressants maintenance therapy of crohn s disease. purine anti-metabolites, meaning interfere synthesis of purines required inflammatory cells. have duration of action of months (slow-acting). both drugs dosed @ 1.5 2.5 mg/kg, literature supporting use of higher doses.

a cochrane systematic review included 13 randomized controlled trials, concluded azathioprine , 6-mercaptopurine not effective inducing remission when person has crohn s disease.

azathioprine , 6-mp may useful following indications:

maintenance therapy azathioprine or 6-mercaptopurine may lead people active crohn s take less steroid medication. may lower side effects related steroid treatments.
fistulizing disease
maintenance of remission after surgery crohn s disease
a combination of azathioprine , infliximab treatment may more effective single dose of infliximab induce steroid-free remission people active crohn s disease.

azathioprine treatment may lead rare life-threatening side effects. rare side effects include leukopenia or pancreatitis. there may increased risk of lymphoma associated azathioprine or 6-mercaptopurine treatment.

azathioprine listed united states fda human carcinogen. however, confers considerably less morbidity , mortality corticosteroids.