Azathioprine for prevention of postoperative recurrence in Crohn's disease

The clinical relapse rate after surgery for Crohn's disease in prospective studies is about 40% at 2 years in people who receive no postoperative prop hylaxis. Thiopurines (azathioprine and 6-mercaptopurine) are likely to be t he most effective pharmacotherapy for preventing postoperative relapse: abo ut four patients need to be treated for 2 years to prevent one clinical rel apse. The factors that help to identify patients at highest risk of relapse are discussed, along with the reasons for the choice of thiopurine, dose a nd duration of therapy. Other measures to reduce the relapse rate are addre ssed. (C) 2001 Lippincott Williams & Wilkins.