Abstract
Azathioprine is approved by the FDA for use as an adjunct for the prevention of renal homotransplantation rejection. Some recently published papers have reported that this drug has been used in various "autoimmune" disorders. Although more controlled studies are required to determine the precise role of this drug for these conditions, clearly, azathioprine is a valuable steroid-sparing agent and has specific beneficial effects in rheumatoid arthritis and systemic lupus erythematosus. Its use remains investigational, since it is not approved by the FDA for these disorders. Further, the physician should carefully consider whether the benefits derived from its use in chronic disease outweigh both the short-term toxicity of infection and bone-marrow suppression and the potential long-term hazards of malignant transformation and genetic damage.
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