Drug Database
AZ

azathioprine (azathioprine, Salix / Azasan / Azasan)

✓ Approved

Salix · Small Molecule · Small Molecule

What is azathioprine?

azathioprine is a small molecule developed by Salix. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namesazathioprine, Salix, Azasan, Azasan
CompanySalix
Drug ClassSmall Molecule
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Salix

Therapeutic Indications

azathioprine is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Musculoskeletal and connective tissue disordersRheumatoid arthritis✓ Approved
Immune system disordersSolid organ transplant rejection✓ Approved

Related Research Articles

PubMedJPGN reports2026-10-15

Nudix hydrolase 15 deficiency and azathioprine toxicity in a liver transplant recipient: A case report.

Nguyen Jenny Q JQ, Rodriguez Natalie N, Chapman Kimberly A KA, Deardorff Matthew A MA et al.

Thiopurines, such as azathioprine (AZA), are among the immunosuppressants used to prevent allograft rejection. Thiopurines are metabolized by thiopurine S-methyltransferase (TPMT) and nudix hydrolase 15 (NUDT15) enzymes, and their functions are highly influenced by genetic variation. We present a 6-year-old female with recurrent acute cellular rejection and steroid-induced glaucoma due to high-dose corticosteroid therapy. Consequently, AZA was incorporated into her calcineurin-inhibitor-based regimen to reduce steroid dose. Within 33 days of initiating AZA, alopecia and pancytopenia developed despite confirmed TPMT enzyme activity with normal phenotype and low 6-Thioguanine and 6-Methylmercaptopurine levels in the blood. Pharmacogenomic analysis revealed an NUDT15 *3/*3 genotype, indicating two "no function" alleles, classified as NUDT15 poor metabolizer at high risk of myelosuppression with standard thiopurine doses. Liver donor pharmacogenomic testing was not performed. This case highlights the consideration of pharmacogenomic testing for recipient and donor prior to thiopurine use in liver-transplant recipients.

PMID 42877613
Read full article →
PubMedJHEP reports : innovation in hepatology2026-10-15

Azathioprine versus mycophenolate mofetil in treatment-naive autoimmune hepatitis: 3-year follow-up of the CAMARO-trial.

Slooter Charlotte D CD, Snijders Romée Jalm RJ, Stoelinga Anna E C AEC, Gerrits Katinka M A KMA et al.

The CAMARO trial demonstrated superior short-term tolerability and response rates of mycophenolate mofetil (MMF) versus azathioprine (AZA), both combined with prednisolone, in treatment-naïve autoimmune hepatitis (AIH). We evaluated long-term outcomes. Patients enrolled in the multicenter randomized CAMARO trial were retrospectively followed for up to 3 years after treatment initiation. Co-primary endpoints were trial-assigned treatment with normalized alanine aminotransferase (ALT) at 3 years and time to biochemical response (normalization of ALT and immunoglobulin G). Three-year follow-up was available for 67 patients (96%; 30 AZA, 37 MMF). At 3 years, 57% versus 76% remained on trial-assigned treatment with normalized ALT (p = 0.099). Median time to biochemical response was 64 versus 16 weeks (adjusted HR 2.74, 95% CI 1.49-5.06; p = 0.001). Among patients without ALT normalization at 24 weeks, 6/12 AZA-treated and 6/11 MMF-treated patients subsequently normalized ALT. Among patients remaining on randomized treatment at 24 weeks, subsequent treatment discontinuation occurred in 5/24 (21%) with AZA and 7/37 (19%) with MMF. Steroid-free ALT normalization (64% vs. 66%) and adverse event rates during year 3 (70% vs. 74%) were comparable (both p > 0.05). Five-year liver-related event-free survival was 70% (95% CI 55-93%) with AZA and 85% (95% CI 71-100%) with MMF (p = 0.080). MMF was associated with faster biochemical response and numerically better overall tolerability. Among patients tolerating their assigned treatment during the initial treatment phase, subsequent outcomes were comparable between AZA and MMF. The substantial treatment burden with both therapies highlights the need for improved treatment options. NCT02900443.

PMID 42880409
Read full article →
PubMedFrontiers in immunology2026-10-15

Anti-interferon-γ autoantibodies: immunopathogenesis, diagnostic innovation, and emerging therapeutic strategies in an adult-onset immunodeficiency.

Tsai Chin-Shiang CS, Cheng Aristine A, Naz Farha F

Adult-onset immunodeficiency with anti-interferon-γ autoantibodies (AIGA) is a rare acquired immunodeficiency increasingly recognized in East and Southeast Asia, characterized by disseminated infections with nontuberculous mycobacteria and other intracellular pathogens. Recent studies have refined our understanding of its immunopathogenesis, including HLA-linked susceptibility, epitope-specific neutralization of IFN-γ, and molecular mimicry, while highlighting persistent gaps in diagnosis and treatment. This Perspective synthesizes emerging evidence into a clinically oriented framework spanning diagnosis, monitoring, and immunomodulatory therapy. We discuss functional confirmation of AIGA, repurposing of the QuantiFERON-TB platform as an accessible screening strategy, and quantitative titers and ¹8F-FDG PET as complementary biomarkers of disease activity and treatment response. We propose a clinical decision pathway in which refractory or progressive infection, rather than a fixed titer threshold, triggers immunomodulation, with rituximab and cyclophosphamide as the best-supported induction strategies, daratumumab reserved for refractory cases, and emerging AIGA-specific evidence supporting azathioprine for maintenance. Recognizing heterogeneous access to specialized testing and biologics across AIGA-endemic regions, we propose a resource-stratified approach integrating widely available markers with referral-based testing and resource-adapted treatment. We also highlight emerging antigen-specific strategies, including chimeric autoantibody receptor T cells engineered to eliminate autoantibody-producing B cells, as a future direction toward durable remission. Finally, we outline priorities for prospective validation and biomarker-guided therapy.

PMID 42876531
Read full article →
PubMedFrontiers in medicine2026-10-15

Long-term upadacitinib treatment in a patient with atopic dermatitis, bullous pemphigoid, and alopecia areata: a case report and review of the literature.

Triolo Sara S, Bruni Manfredo M, Magnanimi Lina Maria LM, De Berardinis Andrea A et al.

Atopic dermatitis (AD), bullous pemphigoid (BP), and alopecia areata (AA) are immune-mediated dermatologic diseases characterized by distinct clinical features but partially overlapping immunopathogenic mechanisms. Their coexistence in a single patient is uncommon and may pose significant diagnostic and therapeutic challenges. We report the case of a 33-year-old woman with long-standing moderate-to-severe AD who subsequently developed BP, confirmed by histopathology and direct immunofluorescence. Initial treatment with systemic corticosteroids and conventional immunosuppressants, including azathioprine followed by cyclosporine, resulted in only transient improvement and was limited by adverse effects. Dupilumab was therefore initiated, leading to marked improvement of BP while maintaining remission of AD. However, after approximately six months of therapy, the patient developed new-onset patchy AA. Dupilumab was discontinued, and treatment was switched to upadacitinib, a selective Janus kinase 1 (JAK1) inhibitor. Early clinical improvement was observed after six weeks, with progressive hair regrowth and stable BP activity. Complete remission of BP was achieved after twelve weeks and complete remission of AA after twenty-four weeks, while remission of AD was maintained. Disease control was sustained throughout a twenty-four -month follow-up, without significant adverse events. This case underscores the diagnostic and therapeutic complexity associated with the coexistence of multiple immune-mediated dermatologic diseases. The sequential emergence of AD, BP, and AA highlights the challenges posed by overlapping inflammatory pathways and the need for alternative therapeutic strategies when pathway-specific treatments prove insufficient or poorly tolerated. These observations support the concept that broader immunomodulatory approaches targeting shared signaling pathways may enable simultaneous control of multiple inflammatory conditions. In this context, inhibition of the JAK-STAT pathway may represent a promising integrated therapeutic strategy in selected patients with complex immune-mediated dermatologic comorbidities.

PMID 42876461
Read full article →
PubMedEuropean journal of case reports in internal medicine2026-10-15

Behçet's Disease in Non-Endemic Areas: A Delayed Diagnosis in A Young Male With Recurrent Bipolar Aphthosis.

Chávez Mauricio Daniel Cisneros MDC, Revilla Diego Antonio Mendoza DAM, Madrigal Victor Gabriel Jimenez VGJ

Behçet's disease (BD) is a rare chronic multisystem inflammatory disorder characterized by vasculitis of vessels of any caliber. It is classically associated with populations along the ancient Silk Road (from the Mediterranean basin to the Far East), but increasing numbers of cases are now reported in non-endemic regions, where delayed diagnosis is common due to low clinical suspicion and the absence of specific diagnostic biomarkers. We report the case of a 28-year-old man from Mexico with an 18-month history of recurrent painful oral ulcers, later associated with genital ulcers, arthralgias, and cutaneous lesions. The patient had been previously evaluated by multiple physicians and received several empirical treatments without improvement. Physical examination revealed multiple oral and genital ulcers, erythematous macular lesions on the palms and soles, and acneiform lesions on the back. Laboratory and immunological studies were unremarkable, and ophthalmological evaluation was normal. After exclusion of infectious and autoimmune diseases, Behçet's disease was suspected. The patient met the International Criteria for Behçet's Disease (ICBD, 2014) with a total of 5 points. Treatment with azathioprine and prednisone led to progressive clinical improvement. This case highlights the diagnostic challenges of Behçet's disease in non-endemic regions. Awareness of its heterogeneous clinical spectrum and the use of validated clinical criteria are essential to avoid diagnostic delay and prevent irreversible organ damage. Behçet's disease should be suspected in patients with recurrent bipolar aphthosis, even in non-endemic regions.The absence of specific biomarkers and histological findings contributes significantly to delayed diagnosis.The International Criteria for Behçet's Disease (ICBD, 2014) provide a sensitive and practical clinical tool for recognizing incomplete but clinically relevant forms of the disease.

PMID 42877807
Read full article →
PubMedNutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition2026-10-14

Severe malnutrition and persistent myopenia despite weight recovery in newly diagnosed stricturing Crohn's disease: A case report.

Costa Beatriz Gabriela da BGD, Nobre Jeniffer Naomy JN, Yoshihara Ryan Nunes Yoshio RNY, Spiller Amanda Luísa AL et al.

Protein-energy malnutrition is a common complication in Crohn's disease (CD). In addition to weight loss, patients may develop significant alterations in body composition, including skeletal muscle depletion, which can negatively affect clinical outcomes and quality of life. Herein, we report on a patient with newly diagnosed CD who presented with severe malnutrition and myopenia, which persisted despite improvements in nutritional intake and body weight. A 27-year-old woman was admitted with abdominal pain, decreased appetite, nausea, vomiting, and progressive weight loss (10 kg, 22% of her usual body weight). Based on clinical presentation, family history, and magnetic resonance enterography findings, stricturing CD was diagnosed. Nutritional assessment revealed severe malnutrition (body weight, 31 kg; body mass index, 12.26 kg/m2; phase angle, 4.4°, intracellular-to-extracellular mass ratio, 0.75). Computed tomography-based body composition analysis demonstrated marked skeletal muscle depletion (skeletal muscle index, 27.5 cm2/m2), confirming myopenia. The patient was treated with corticosteroids, infliximab, azathioprine, and multidisciplinary nutritional management. After 12 months of follow-up, she achieved clinical remission and gained approximately 25% of her initial body weight. Despite significant weight recovery and improved dietary intake, computed tomography (CT) revealed low skeletal muscle mass and increased visceral and subcutaneous adipose tissue, indicating persistent myopenia. This case highlights the importance of comprehensive body composition assessments in CD. Clinical remission and weight gain may not accurately reflect recovery of skeletal muscle mass. Early nutritional evaluation and longitudinal body composition monitoring may be helpful in the management of patients with CD to identify persistent muscle depletion and optimize long-term outcomes.

PMID 42872489
Read full article →

+9996 more articles available with a free account

Sign up free to view all articles →

Ask about azathioprine