Research Article
Volume 9 Issue 3 - 2022
Malignancy Risk and Safety Issues of Azathioprine in Patients with Inflammatory Bowel Disease: Clinical Experience from a Referral Center
Georgios Kourtis1, Fotios S Fousekis2, Ioannis V Mitselos2, Maria Saridi3*, Eleni Albani4, Konstantinos Vlachos5, Konstantinos H Katsanos2 and Dimitrios K Christodoulou2
1Department of Nursing, General Hospital “Sotiria”, Athens, Greece
2Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece
3General Department, University of Thessaly, Lamia, Greece
4Department of Nursing, University of Patra, Patra, Greece
5Department of Surgery, University Hospital of Ioannina, Ioannina, Greece
*Corresponding Author: Maria Saridi, General Department, University of Thessaly, Lamia, Greece.
Received: February 06, 2022; Published: February 25, 2022


Background: Despite the development of new agents for the treatment of inflammatory bowel disease (IBD), azathioprine (AZA) is widely used as monotherapy or combination therapy for the induction and maintenance of remission in both Crohn’s disease (CD) and ulcerative colitis (UC). The aim of this study was to investigate both the prevalence of malignancy development in IBD patients receiving AZA as well as long-term safety of AZA and the management of adverse events.
Methods: Data were retrospectively extracted from the patient records of the Gastroenterology Department of University hospital of Ioannina from 2003 to 2019.
Results: 222 IBD patients treated with AZA, under regular follow-up intervals were included in the study. 65.6% of IBD patients (146/222) had CD and 34.4% had UC (76/222). The mean duration of AZA administration was 51 months (range: 0-135 months). The most common dose of AZA was 100mg/day (range: 50-200mg). The most common adverse events were gastrointestinal symptoms (8.6%, 18/222), leucopenia (2.7%, 6/222), hepatotoxicity (5.4%, 12/222) and pancreatitis (1.8%, 4/222). Two patients were diagnosed with basal cell cancer, while no hematological malignancy was detected. Infections were recorded in 19 patients (8.6%) of whom 6 needed hospitalization.          
Conclusion: According to this retrospective observational study, approximately one-third of IBD patients receiving AZA presented clinical significant adverse event during follow-up. Azathioprine withdrawal or dose reduction was needed in 47 (21%) patients.


Keywords: Azathioprine; Safety; Thiopurine; Inflammatory Bowel Disease; Ulcerative Colitis; Crohn’s Disease


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Citation: Maria Saridi., et al. “Malignancy Risk and Safety Issues of Azathioprine in Patients with Inflammatory Bowel Disease: Clinical Experience from a Referral Center”. EC Gastroenterology and Digestive System 9.3 (2022): 17-25.

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