Long-term use of azathioprine (AZA) is associated with a better disease course in patients with early Crohn's disease (CD), according to a study published online Sept. 22 in the Journal of Gastroenterology and Hepatology. Yun Qiu, from Sun Yat-sen University in China, and colleagues evaluated the impact of AZA on disease progression in a cohort of 190 patients with early CD (disease duration ≤18 months) and no previous use of disease-modifying agents. The researchers found that over a median follow-up of 57 months, 31 patients underwent abdominal surgeries, 48 patients were hospitalized, and 68 patients experienced clinical flares. The cumulative rate of remaining free of CD-related bowel surgery, hospitalization, and flares after five years on AZA treatment was 0.65, 0.59, and 0.39, respectively. Prior bowel resection (hazard ratio [HR], 9.23; smoking (HR, 4), and hemoglobin <110 g/L at the time of initiation of AZA (HR, 4.36) were independent predictors of CD-related operations. AZA treatment duration >36 months (HR, 0.04) was associated with reduced CD-related operations. "Prolonged use of AZA was associated with a more favorable disease course of early CD, evident as a lower risk of CD-related surgery," conclude the authors. Several authors disclosed financial ties to the pharmaceutical industry. Source
