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AZA and 6-MP are inactive molecules that require bioactivation via a complex enzymatic metabolism.
A 38-year-old man with ulcerative colitis receiving 6-MP monotherapy underwent a liver biopsy for elevated aminotransferases.
Addressing these concerns, we recently conducted a meta-analysis of studies of women treated with azathioprine, and to a lesser extent, 6-MP, during pregnancy.
Studies have shown that 6-TGN levels are associated with clinical response when AZA or 6-MP is used in the treatment of Crohn's disease.
About 4% of patients on 6-MP or azathioprine will develop leukopenia, and up to 15% will have abnormal liver function test results.
Azathioprine (Imuran[R]) and 6-MP are not considered therapeutic options in patients with mild disease.
6-MP is also used in some cases of ulcerative colitis.
Patients with a history of cancer of any type, definite dysplasia of the colon within the last 5 years, or clinically significant renal or hepatic disease were ineligible, as were pregnant or breast-feeding women, patients who were allergic to AZA or 6-MP, and patients receiving allopurinol.
Many physicians advise discontinuing 6-MP prior to conception, but Dr.
They ought to avoid azathioprine and 6-MP altogether, the gastroenterologist said.