Table 3. Immunomodulator Treatment.
Author (year) | Level of published evidence | No. of patients | Regimen | Outcome |
---|---|---|---|---|
Matsumura et al. (2010)25 | Case report | 1 | • Tacrolimus serum level, 10–15 ng/mL • After 5 mo: 5–10 ng/mL |
• Oral tacrolimus was effective for refractory intestinal BD. • Colonoscopy 33 mo after starting tacrolimus revealed complete disappearance of the ascending colon ulceration. |
Jung et al. (2012)20 | Retrospective | 39 | • AZA, 2.0–2.5 mg/kg (starting dose, 25 mg or 50 mg/day) • 6-MP, 1.0–1.5 mg/kg (starting dose, 0.5 mg/kg) |
• 39 of the 67 patients (58.2%) constantly received thiopurines for maintaining medically or surgically induced remission. • Relapse rates at 1, 2, 3, and 5 yr after remission were 5.8%, 28.7%, 43.7%, and 51.7%. |
Hisamatsu et al. (2014)5 | Japanese consensus statements | - | AZA, 25–50 mg/day | Japanese consensus statements (the 2nd) recommended thiopurines for refractory intestinal BD such as corticosteroid-dependent or -resistant patients. |
Lee et al. (2015)21 | Retrospective | 77 | After surgery: Thiopurine (n=27) • AZA, 2.0–2.5 mg/kg 6-MP, 1.0–1.5 mg/kg 5-ASA (n=50) • 5-ASA, 3–4 g/day |
• Postoperative recurrence rate was lower in patients who received postoperative thiopurines (P=0.050). • The hazard ratio for recurrence was 0.636 (95% CI, 0.130–1.016; P=0.053) for postoperative thiopurine use compared with postoperative 5-ASA. |
Park et al. (2015)23 | Retrospective | 83 | • AZA, 2.0–2.5 mg/kg (6-MP dose was converted to equivalent AZA) • Starting AZA/6-MP dose, 1.0 mg/kg/day |
Leukopenia (WBC count <4,000/µL) during thiopurine maintenance therapy was associated with prolonged remission in patients with IBD and BD during 6 yr. |
Hatemi et al. (2016)3 | Retrospective | 37 | AZA, 2.0–2.5 mg/kg/day | 65% of patients obtained remission and did not relapse during a mean follow-up of 68.6±43.6 mo. |
BD, Behçet's disease; AZA, azathioprine; 6-MP, 6-mercaptopurine; 5-ASA, 5-aminosalicylic acid; WBC, white blood cell.