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- Title
Significant differences between Crohn's disease and ulcerative colitis regarding the impact of body mass index and initial disease activity on responsiveness to azathioprine: results from a European multicenter study in 1,176 patients.
- Authors
Holtmann, Martin H.; Krummenauer, Frank; Claas, Christina; Kremeyer, Kristina; Lorenz, Dirk; Rainer, Olivia; Vogel, Iris; Böcker, Ulrich; Böhm, Stephan; Büning, Carsten; Duchmann, Rainer; Gerken, Guido; Herfarth, Hans; Lügering, Norbert; Kruis, Wolfgang; Reinshagen, Max; Schmidt, Jan; Stallmach, Andreas; Stein, Jürgen; Sturm, Andreas
- Abstract
In a survey comprising 1,176 patients with inflammatory bowel disease (IBD) we recently showed that azathioprine (AZA) beyond 4 years is beneficial in ulcerative colitis (UC) patients and in a subset of Crohn's disease (CD) patients. Here, we show for the first time that azathioprine responsiveness depends on body mass index (BMI). The relationship is reciprocal in UC and CD, with a better outcome in UC patients with a BMI<25 and in CD patients with a BMI>25. These observations are particularly interesting considering the evolving concept of a relationship between fatty metabolism and immune regulation. Additionally, we show that CD patients, but not UC patients, respond better to AZA when it is started in clinical remission. This observation may support data favouring a "hit hard and early" regime in CD. Finally, we were able to demonstrate a decrease in the incidence of CD-related complications requiring surgery through treatment with AZA.
- Subjects
EUROPE; INFLAMMATORY bowel diseases; BODY weight; ULCERATIVE colitis; COLON diseases; CROHN'S disease; ANTI-inflammatory agents; CROHN'S disease diagnosis; ULCERATIVE colitis diagnosis; DISEASE relapse prevention; PREDNISOLONE; COMBINATION drug therapy; COMPARATIVE studies; DRUG administration; IMMUNOSUPPRESSIVE agents; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; SURVEYS; EVALUATION research; BODY mass index; TREATMENT effectiveness; AZATHIOPRINE; THERAPEUTICS
- Publication
Digestive Diseases & Sciences, 2010, Vol 55, Issue 4, p1066
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-009-0846-9