Azathioprine treatment in active chronic hepatitis. Evaluation of dose levels.

Abstract

Abstract A retrospective study of 29 patients with active chronic hepatitis treated over 38 different periods with azathioprine was carried out with particular attention to the effects of high (above 1.5 mg/kg) and low (below 1.5 mg/kg) doses. Early side‐effects (within 4 weeks) occurred in 7 of 10 patients using above 2 mg/kg and in 6 of 11 patients on 1.5–2 mg/kg azathioprine. Of the patients treated with the low azathioprine dose only 4 of 17 had early side‐effects. Eighteen patients were treated up to 2 years, among whom 2 of 12 on low dose and 3 of 6 on high dose had late side‐effects. Of 9 patients treated for more than 2 years (average 2 3/4 years) on a low azathioprine dose late side‐effects occurred in 2. The clinical course of the liver disease in these patients showed that 5 of 8 treated on high dose were unchanged or improved compared to 15 of the 21 on the low dose. Serum γ‐globulin and SGPT decreased significantly in the patients on the low azathioprine dose concomitantly with a non‐significant increase in serum albumin. These changes were not less marked on low than on high dose. Our experiences thus favor doses below 1.5 mg/kg when azathioprine is used in active chronic hepatitis.