Azathioprin bei Kollagenosen

Zusammenfassung

Azathioprin wird seit über 50 Jahren in der Therapie von Kollagenosen eingesetzt. Kontrollierte Studien liegen vorwiegend nur beim SLE vor. Generell kann von einem glukokortikoidsparenden Effekt ausgegangen werden (Empfehlungsgrad D). Bei der Therapie der Lupusnephritis ist die Wirksamkeit von Azathioprin als Erhaltungstherapie nach Induktion einer Remission erwiesen (Empfehlungsgrad A). Es ist auch eine Wirksamkeit von Azathioprin bei anderen Organmanifestationen anzunehmen, die Studienlage ist jedoch dünn (Empfehlungsgrad C–D). Die Wirksamkeit von Azathioprin bei Myositiden ist nicht ausreichend erwiesen (Empfehlungsgrad D). Es gibt keine sicheren Hinweise für eine Wirksamkeit von Azathioprin bei der systemischen Sklerose. Beim Sjögren-Syndrom mit extraglandulären Organmanifestationen oder Vaskulitis ist Azathioprin in Kombination mit Glukokortikoiden indiziert (Empfehlungsgrad D).

Abstract

Azathioprine has been used in the treatment of connective tissue diseases for more than 50 years. The efficacy of azathioprine has been mainly investigated in systemic lupus erythematosus. The drug is generally assumed to have a glucocorticoid-sparing effect (strength of recommendation: D). Azathioprine has proven effective in the maintenance therapy for lupus nephritis after induction of remission (strength of recommendation: A). One can also assume that the drug is effective in the treatment of other organ manifestations, but evidence from randomised controlled trials is scarce (strength of recommendation: C–D). The efficacy of azathioprine in the treatment of myositis has not been sufficiently proven (strength of recommendation: D). In addition, there is no evidence reliably demonstrating the efficacy of the drug in systemic sclerosis. Azathioprine in combination with glucocorticoids is recommended for the treatment of Sjögren’s syndrome with extraglandular manifestations or vasculitis (strength of recommendation: D).

Schlüsselwörter

Azathioprin - Lupus erythematodes - Myositis - systemische Sklerose - Sjögren-Syndrom

Key words

azathioprine - systemic lupus erythematosus - myositis - systemic sclerosis - Sjögren’s syndrome

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