Serum biochemistry in relation to the action of azathioprine in rheumatoid arthritis

Abstract

In a long-term study we have been comparing biochemical changes in the blood of patients with classical or definite rheumatoid arthritis (RA) when groups of patients are treated for the first time with specific anti-rheumatoid drugs for a six-month period. One such group was treated for 26 weeks with azathioprine. Biochemical and clinical assessments were made at each of 10 clinic visits during the treatment period. Side-effects prevented six patients completing the study. Clinical improvement in the remaining patients was accompanied by a reduction in acute phase proteins, increases in total serum sulphydryl and serum histidine, but little or no change in immunological variables. Comparison of correlation matrices constructed between clinical and laboratory variables for azathioprine and drugs previously tested suggests that azathioprine is more effective than a control group on aspirin alone and in some ways comparable with D-penicillamine.

Immunological monitoring of azathioprine treatment in multiple sclerosis patients

“…In agreement with the biological action of azathioprine (mainly affecting cycling cells and primary immune responses) [40], although a trend to a reduction in serum IgM levels was observed, in agreement with other studies [8,28], no significant reduction occurred in the levels of serum IgG. In previous studies, the reduction in serum IgG in azathioprine-treated patients can often be attributed to concomitant steroid medication [36].…”

Disease-Modifying Antirheumatic Drugs

“…95 ) While there have been more than 11 double-blind, randomised trials examining the efficacy of azathioprine, most of these studies were small. [94,96) The largest studies assessing the tolerability of azathioprine include those of Whisnant and Pelky, [97) and Singh et aU 98 ) Whisnant and Pelky [97) tabulated data on 542 rheumatoid arthritis patients in 24 trials, while Singh et al,f98) surveyed 546 patients in a post-marketing surveillance. [96) Interestingly, this is the only DMARD which is frequently associated with an increased erythrocyte sedimentation rate in the face of clinical improvement.…”