Purine Analogues Azathioprine and 6Mercaptopurine

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 [8]. 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) [12].

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