Azathioprine in IBD


Immunomodulating agents like azathioprine and its active metabolite mercaptopurine are often used in inflammatory bowel disease. These agents serve either as alternatives when corticosteroids are not tolerated or as adjunctive therapy when the disease is refractory.

Azathioprine is converted to 6-MP, which is then metabolized to thioinosinic acid, which inhibits purine ribonucleotide synthesis and cell proliferation and inhibits natural killer cell activity and cytotoxic T-cell function. See also azathioprine in the immunology section.


The greatest benefit from adding azathioprine to an ulcerative colitis regimen is: