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

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 ; Galle, Peter R. ; Hommes, Daan W. ; D’Haens, Geert ; Rutgeerts, Paul ; Neurath, Markus F.

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Details

Item type:	Article
Journal or Publication Title:	Digestive Diseases and Sciences
Publisher:	SPRINGER
Place of Publication:	DORDRECHT
Volume:	55
Number of Issue or Book Chapter:	4
Page Range:	pp. 1066-1078
Date:	2010
Institutions:	Medicine > Lehrstuhl für Innere Medizin I
Identification Number:	Value Type 10.1007/s10620-009-0846-9 DOI
Keywords:	INFLAMMATORY-BOWEL-DISEASE; RECEPTOR EXPRESSION; ABDOMINAL-TRAUMA; ADIPOSE-TISSUE; T-LYMPHOCYTES; TERM; INFLIXIMAB; MANAGEMENT; LEPTIN; TRIAL; Azathioprine; Crohn's disease; Ulcerative colitis; Disease activity; Body mass index
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	66214

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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 ...

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.

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