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Co-prescribing azathiopurine or 6-mercaptopurine and 5-aminosalicylate compounds in ulcerative colitis

Mayberry, H.1; Moshkovska, T. MD1; Mayberry, J. F. MD1*

doi: 10.1002/ibd.20750
Original Article

Background: A total of 254 senior consultant gastroenterologists with valid e-mail addresses were identified from the membership list of the British Society of Gastroenterology (BSG) 2007.

Methods: They were sent by e-mail a questionnaire which dealt with aspects of clinical practice and addressed cancer prevention in ulcerative colitis (UC). Replies were received from 97 clinicians (38% response rate).

Results: Ninety-one (94%) advised patients with established UC to take 5-aminosalicylate (5-ASA) compounds for life. Seventy-two of the 91 (79%) clinicians co-prescribed 5-ASA compounds with immune modulators for patients with UC. Only 3 clinicians advised patients to take folic acid as a daily supplement. A median of 20% (interquartile range 10%–50%) of their patients with UC were co-prescribed a 5-ASA compound and azathioprine or 6-mercaptopurine. Of these, a median of 3.5% (interquartile 1%–5%) developed neutropenia.

Conclustions: Future research needs to be directed at the long-term maintenance treatment and to address questions about which drugs should be used, in what combinations, and with what frequencies.

1 Department of Digestive Diseases, Leicester General Hospital, Leicester, United Kingdom

* Department of Digestive Diseases, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK


Received 22 July 2008; Accepted 5 August 2008

Published online 6 October 2008 in Wiley InterScience (

© Crohn's & Colitis Foundation of America, Inc.
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