[Immunosuppressive therapy for inflammatory bowel disease: consensus by the Austrian working group on IBD]

Z Gastroenterol. 2004 Sep;42(9):1033-45; discussion 1046-7. doi: 10.1055/s-2004-813500.
[Article in German]

Abstract

Azathioprine (AZA) or 6-mercaptopurine (6-MP) are the immunosuppressive drugs of choice in the treatment of inflammatory bowel disorders (IBD). Optimal dosage for AZA is around 2.5 mg/kg body weight and induction of remission by these drugs may take 6 - 7 months. Intramuscularly applied Methotrexate (MTX) is the second choice, while its efficacy starts earlier than that of AZA; studies assessing oral low-dose MTX treatment are lacking. Cyclosporin is the standard treatment in case of steroid-refractory severe ulcerative colitis. This drug may also be used in patients with severe extraintestinal manifestations of IBD. Regarding other immunosuppressive drugs such as mycophenolic acid or 6-thioguanine respective controlled clinical study data are not available. The risk of malignancy using immunosuppressive drugs such as AZA is low and furthermore, especially AZA and 6-MP can be used rather safely during pregnancy.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Azathioprine / administration & dosage
  • Azathioprine / therapeutic use
  • Colitis, Ulcerative / drug therapy
  • Crohn Disease / drug therapy
  • Cyclosporine / administration & dosage
  • Cyclosporine / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Inflammatory Bowel Diseases / drug therapy*
  • Injections, Intramuscular
  • Male
  • Mercaptopurine / administration & dosage
  • Mercaptopurine / therapeutic use
  • Methotrexate / administration & dosage
  • Methotrexate / therapeutic use
  • Placebos
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Remission Induction
  • Retrospective Studies
  • Safety
  • Time Factors

Substances

  • Immunosuppressive Agents
  • Placebos
  • Cyclosporine
  • Mercaptopurine
  • Azathioprine
  • Methotrexate