AZATHIOPRINE AND ENDOSCOPIC MUCOSAL HEALING: ABOUT A SERIES OF 67 CASES

Aims:

Endoscopic mucosal healing has now become a major therapeutic goal that seems to improve the prognosis of IBD. Immunosuppressive drugs play an important role in the treatment and maintenance of remission during IBD. The aim of our work is to evaluate the rate of endoscopic mucosal healing obtained with Azathioprine after a mean therapeutic retreat of 4 years.

Methods:

Of a total of 996 patients with IBD, 184 are under immunosupprive treatement, of which 67 patients have been selected for this study. This is a retrospective study of 67 cases of IBD followed in our service. We Included patients treated with Azathioprine who underwent endoscopy after an average of 4 years of treatment.

Results:

Our study included 67 patients, 58.2% of patients were women, with an average age of 48 years and extreme ages of 20 to 76 years. 89.5% of patients had Crohn's disease with ileocolic localization then pure colic in 71.6% and 21.6% respectively. The rest had a Ulcerative colitis. 28 patients (41.7%) with Crohn's disease underwent surgery before taking immunosuppressants. All of our patients underwent endoscopy after a median of 4-years period of treatment with Azathioprine before deciding on interrupting the treatment. This endoscopy showed endoscopic mucosal healing in 32.8% of patients, defined by an absence of ulcerations, while patients were clinically and biologically in remission.

Conclusions:

In our study, the therapeutic goal of mucosal healing during treatment with Azathioprine was possible in almost one third of our patients, which remains a good therapeutic alternative considering our context and in case of lack of anti-TNF.