Purine analogues are indicated in fistulae, severe perianal changes, extensive pathological changes of the small and large intestine not responsive to other drugs and when there is a necessity to decrease the dosage of steroids.
A basic effect of purine analogues is a decrease in cellular cell response . The effects of these drugs can be seen after 3-6 months of therapy; therefore, they are mainly used as a supportive treatment. They can be beneficial in fistula healing and decrease the need for glucocorticoids use. Suggested dosage of azathioprine is from 2 to 2.5 mg/kg/day, 6-mercap-topurine is from 1 to 1.5 mg/kg/day.
Azathioprine was effective in 67% of patients compared to 8% in the placebo group, it was successful in fistula closing in 31% of patients vs. 6% in the control group, and led to a decrease of steroid dosage in 75% of patients (32% in the placebo group) .
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