EFFICACY OF 6-MERCAPTOPURINE IN THE TREAT MENT OF INFLAMMATORY BOWEL-DISEASE

Objective: To assess the efficacy of 6-mercaptopurine in I.B.D. treatm ent. Patients: 21 patients with chronic active disease (8 patients wit h ulcerative colitis and 13 with Crohn's disease) and mean follow-up 5 years for both diseases (range ulcerative colitis 1-11 and Crohn's di sease 1-14 years, respectively), The indications of inmunosuppressor t reatment were: corticosteroid dependence (3 ulcerative colitis; 6 Croh n's disease), refractory disease (5 ulcerative colitis; 4 Crohn's dise ase), fistulae (5 Crohn's disease) and perianal disease (4 Crohn's dis ease), All patients received a mean dose of 30 mg/day of prednisone, C omplete, partial and clinical remission, o failure of treatment are de fined. Results: The mean dose of 6-mercaptopurine was 90 mg/day with a response mean time of 3.4 months and 12 months of duration (range 1-3 6), Complete or partial clinical remission was achieved in 77.7% of al l the patients (steroid dependent 88.8%, refractory disease 77.7%, fis tulae 40%, perianal disease 100% of all the patients (steroid dependen t 88.8%, refractory disease 77.7%, fistulae 40%, perianal disease 100% ), in 87% of ulcerative colitis patients (steroid dependent 100%, refr actory 80%) and in 61.5% of Crohn's disease patients (steroid dependen t 83.7%, refractory disease 75%), Secondary effects were observed in t wo patients. Conclusions: Our results suggest that 6-mercaptopurine is an effective and safe drug in the treatment of patients with ulcerati ve colitis and Crohn's disease in corticosteroid dependent, refractory and perianal disease, its efficacy being less in fistulae.