Abstract
Azathioprine is a synthetic purine analog. Although the drug has been used in clinical practice for approximately 50 years, the mechanism of immunosuppressive action remains poorly understood. In the late 1960s, the use of azathioprine to manage uveitis was first suggested. Subsequently, multiple case series and two randomized, placebo-controlled clinical trials have been published in support of the usefulness of this medication in patients with inflammatory eye disease.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Derijks LJ, Gilissen LP, Hooymans PM et al (2006) Review article: thiopurines in inflammatory bowel disease. Aliment Pharmacol Ther 24:715–729
Evidence-Based Medicine Working Group (2002) Users’ guide to the medical literature. AMA Press, Chicago, p 12
Gauba V, Saldanha M, Vize C et al (2006) Thiopurine methyltransferase screening before azathioprine therapy. Br J Ophthalmol 90:923–924
Gion N, Stavrou P, Foster CS (2000) Immunomodulatory therapy for chronic tubulointerstitial nephritis-associated uveitis. Am J Ophthalmol 129:764–768
Goebel JC, Roesel M, Heinz C et al (2011) Azathioprine as a treatment option for uveitis in patients with juvenile idiopathic arthritis. Br J Ophthalmol 95:209–213
Hamuryudan V, Ozyazgan Y, Hizli N et al (1997) Azathioprine in Behcet's syndrome: effects on long-term prognosis. Arthritis Rheum 40:769–774
Jabs DA, Rosenbaum JT, Foster CS et al (2000) Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol 130:492–513
Jayson MI, Easty DL (1977) Ulceration of the cornea in rheumatoid arthritis. Ann Rheum Dis 36:428–432
Kim SJ, Yu HG (2007) The use of low-dose azathioprine in patients with vogt-koyanagi-harada disease. Ocul Immunol Inflamm 15:381–387
Kiss S, Ahmed M, Letko E et al (2005) Long-term follow-up of patients with birdshot retinochoroidopathy treated with corticosteroid-sparing systemic immunomodulatory therapy. Ophthalmology 112:1066–1071
Mathews JD, Crawford BA, Bignell JL et al (1969) Azathioprine in active chronic iridocyclitis. A double-blind controlled trial. Br J Ophthalmol 53:327–330
McLeod HL, Siva C (2002) The thiopurine S-methyltransferase gene locus – implications for clinical pharmacogenomics. Pharmacogenomics 3:89–98
Michel SS, Ekong A, Baltatzis S et al (2002) Multifocal choroiditis and panuveitis: immunomodulatory therapy. Ophthalmology 109:378–383
Moore CE (1968) Sympathetic ophthalmitis treated with azathioprine. Br J Ophthalmol 52:688–690
Newell FW, Krill AE (1967) Treatment of uveitis with azathioprine (Imuran). Trans Ophthalmol Soc U K 87:499–511
Pasadhika S, Kempen JH, Newcomb CW et al (2009) Azathioprine for ocular inflammatory diseases. Am J Ophthalmol 148:500–509
Patel AA, Swerlick RA, McCall CO (2006) Azathioprine in dermatology: the past, the present, and the future. J Am Acad Dermatol 55:369–389
Saadoun D, Wechsler B, Terrada C et al (2010) Azathioprine in severe uveitis of Behcet’s disease. Arthritis Care Res 62:1733–1738
Schatz CS, Uzel JL, Leininger L et al (2007) Immunosuppressants used in a steroid-sparing strategy for childhood uveitis. J Pediatr Ophthalmol Strabismus 44:28–34
Silman AJ, Petrie J, Hazleman B et al (1988) Lymphoproliferative cancer and other malignancy in patients with rheumatoid arthritis treated with azathioprine: a 20 year follow up study. Ann Rheum Dis 47:988–992
Tamesis RR, Rodriguez A, Christen WG et al (1996) Systemic drug toxicity trends in immunosuppressive therapy of immune and inflammatory ocular disease. Ophthalmology 103:768–775
Tiede I, Fritz G, Strand S et al (2003) CD28-dependent Rac1 activation is the molecular target of azathioprine in primary human CD4+ T lymphocytes. J Clin Invest 111:1133–1145
Vianna RN, Ozdal PC, Deschenes J et al (2006) Combination of azathioprine and corticosteroids in the treatment of serpiginous choroiditis. Can J Ophthalmol 41:183–189
Vroom F, de Walle HE, van de Laar MA et al (2006) Disease-modifying antirheumatic drugs in pregnancy: current status and implications for the future. Drug Saf 29:845–863
Yazici H, Pazarli H, Barnes CG et al (1990) A controlled trial of azathioprine in Behcet’s syndrome. N Engl J Med 322:281–285
Kempen JH, Daniel E, Dunn JP et al (2007) Overall and cancer related mortality among patients with ocular inflammation treated with immunosuppressive drugs: retrospective cohort series. BMJ 2009:339:b2480
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Smith, J.R. (2016). Azathioprine. In: Zierhut, M., Pavesio, C., Ohno, S., Orefice, F., Rao, N. (eds) Intraocular Inflammation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-75387-2_22
Download citation
DOI: https://doi.org/10.1007/978-3-540-75387-2_22
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-75385-8
Online ISBN: 978-3-540-75387-2
eBook Packages: MedicineMedicine (R0)