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Side effects associated with the 5-ASA agents include interstitial nephritis, pleuropericarditis, leukopenia and pancreatitis.

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What SIDE EFFECTS can this medicine cause?

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Outline the use of different formulations of oral and topical mesalamine in the treatment of these disease states.

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Treatment of Behcet's syndrome is symptomatic and empirical.

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These interactions are usually transient and mild until a new steady state is achieved.

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From December 2009 through October 2011, a total of 77 patients were enrolled in the combination-therapy group and 78 in the placebo group ( Figure 1 Enrollment and Outcomes.

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The risk for cancer starts 10 years after the diagnosis, and we think that active inflammation also plays a role in increased risk.

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Prednisolone and azathioprine represent first choice drugs, whereas several second choice options are recommended and should be considered.

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In contrast, several other studies that either had very small samples or used other, nonvalidated instruments to measure efficacy have reported higher rates of treatment success with azathioprine.

Azathioprine is a prodrug that must first be activated to form thioguanine nucleotides (TGNs), the major active metabolites.

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In these individuals, lower initial doses can be used.

Additional side effects include lowered resistance to infection and a small chance of developing cancers such as lymphoma and skin cancers.

Glucocorticoids and azathioprine are most useful in patients with signs of inflammation.

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The proposed indications (uses) for this product are: (1) Reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in patients with moderately to severely active rheumatoid arthritis (in combination with methotrexate (MTX) or used alone); (2) reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis in patients ages 2 and older; (3) reducing signs and symptoms, inhibiting the progression of structural damage of active arthritis, and improving physical function in patients with psoriatic arthritis (in combination with MTX in patients who do not respond adequately to MTX alone); (4) reducing signs and symptoms in patients with active ankylosing spondylitis; and (5) treatment of adult patients (18 years or older) with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

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Additionally, concomitant administration with prednisone may increase the risk of gastrointestinal ulceration.

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The azathioprine (Imuran) FDA-approved drug label recommends testing for TPMT genotype or phenotype to identify patients who are at increased risk of myelotoxicity: those with low or absent TPMT activity.

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Adalimumab may be superior to azathioprine but further research is needed to confirm these results.

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The value of this panel of biomarkers in the management of patients with IBS needs to be validated.

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