Drug ID:Drug10
Drug Name:Azathioprine
CID:2265
DrugBank ID:DB00993
Modality:Small Molecule
Groups:approved
US Approved:YES
Other Approved:YES
Identifier: NCT03370601, , NCT02413047, , NCT06213857, , NCT02281799, , NCT03101800, , NCT04882683, , NCT03151525, , NCT00984568, , NCT02579733, , NCT01817972
Molecular Formula:C9H7N7O2S
Molecular Weight:277.27 g/mol
Isomeric SMILES:CN1C=NC(=C1SC2=NC=NC3=C2NC=N3)[N+](=O)[O-]
Synonyms:azathioprine; 446-86-6; Azothioprine; Azathioprin; Azamun; Azanin; Azatioprin; Azasan; Ccucol; Imurek
Phase 0: 3
Phase 1: 7
Phase 2: 38
Phase 3: 59
Phase 4: 44
Description:An immunosuppressive antimetabolite pro-drug. It is an imidazolyl derivative of 6-mercaptopurine and many of its biological effects are similar to those of the parent compound. Azathioprine is converted into 6-mercaptopurine in the body where it blocks purine metabolism and DNA synthesis.

Molecular Structure

2D Molecular Structure

Knowledge Graph

dtIDCIDCompound NameGene IDGene NameSpeciesPubMed IDsAction
dt80 2265 Azathioprine 5243 ABCB1 Homo sapiens (human) 17262810 ABCB1 gene polymorphism affects the susceptibility to azathioprine
dt81 2265 Azathioprine 8647 ABCB11 Rattus norvegicus (Norway rat) 27765674 Azathioprine results in decreased expression of ABCB11 mRNA
dt82 2265 Azathioprine 5244 ABCB4 Rattus norvegicus (Norway rat) 27765674 Azathioprine results in increased expression of ABCB4 mRNA
dt83 2265 Azathioprine 1244 ABCC2 Homo sapiens (human) 22623647 Azathioprine results in increased expression of ABCC2 mRNA
dt84 2265 Azathioprine 1244 ABCC2 Rattus norvegicus (Norway rat) 27765674 Azathioprine results in increased expression of ABCC2 mRNA
dt85 2265 Azathioprine 8714 ABCC3 Rattus norvegicus (Norway rat) 27765674 Azathioprine results in increased expression of ABCC3 mRNA
dt86 2265 Azathioprine 10257 ABCC4 Rattus norvegicus (Norway rat) 27765674 Azathioprine results in increased expression of ABCC4 mRNA
dt87 2265 Azathioprine 9429 ABCG2 Rattus norvegicus (Norway rat) 27765674 Azathioprine results in decreased expression of ABCG2 mRNA
dt88 2265 Azathioprine 64240 ABCG5 Rattus norvegicus (Norway rat) 27765674 Azathioprine results in decreased expression of ABCG5 mRNA
dt89 2265 Azathioprine 63874 ABHD4 Homo sapiens (human) 22623647 Azathioprine results in increased expression of ABHD4 mRNA

  • No data available

Phase Distribution
Phase Description
  • Phase 0: Exploratory trials to assess drug behavior in humans
  • Phase 1: Safety trials to determine safe dosage range
  • Phase 2: Efficacy trials to evaluate therapeutic effects
  • Phase 3: Large-scale trials to confirm efficacy and safety
  • Phase 4: Post-marketing surveillance for long-term safety and efficacy

Trial IDTitlePhaseStatusSponsorIndicationsInterventions
NCT04882683 Clinical Study of Cord Blood Mononuclear Cells on Treatment of Hormone-resistant or Hormone-dependent Ulcerative Colitis None UNKNOWN Shandong Qilu Stem Cells Engineering Co., Ltd. Ulcerative Colitis DRUG: Prednisone|DRUG: Azathioprine|DRUG: Adalimu… Details
NCT03151525 Two Therapeutic Strategies for the Maintenance of Remission in Patients With Ulcerative Colitis PHASE4 UNKNOWN Istituto Clinico Humanitas Colitis, Ulcerative DRUG: Azathioprine|DRUG: Infliximab Details
NCT00984568 Conventional Step-Up Versus Infliximab Monotherapy in Patients With Ulcerative Colitis (P05553) PHASE3 TERMINATED Merck Sharp & Dohme LLC Colitis, Ulcerative BIOLOGICAL: Infliximab|DRUG: Prednisolone|DRUG: 5… Details
NCT00537316 Efficacy & Safety of Infliximab Monotherapy Vs Combination Therapy Vs AZA Monotherapy in Ulcerative Colitis (Part 1) Maintenance Vs Intermittent Therapy for Maintaining Remission (Part 2)(Study P04807) PHASE3 TERMINATED Merck Sharp & Dohme LLC Ulcerative Colitis BIOLOGICAL: Infliximab (IFX)|DRUG: Azathioprine (… Details
NCT02579733 Azathioprine Based on Endoscopy After Clinical Remission in Moderate to Severe Ulcerative Colitis PHASE4 TERMINATED Kyungpook National University Hospital Ulcerative Colitis DRUG: Azathioprine|DRUG: Placebo Details
NCT01817972 Cimzia Versus Cimzia Plus Azathioprine in the Treatment of Active Crohn's Disease PHASE3 UNKNOWN Gastroenterology Research of America Crohn's Disease BIOLOGICAL: Certolizumab pegol|DRUG: Azathioprine Details
CTRI/2023/10/058514 Evaluation of effectiveness and safety of oral tofacitinib in patients with Parthenium dermatitis: A prospective interventional open label study - NIL Not Available Not Recruiting AIIMS, New Delhi Health Condition 1: L237- Allergic contact dermat… Intervention1: Oral Tofacitinib: Tofacitinib is a… Details
ISRCTN95420128 Subcutaneous CT-P13 monotherapy versus combination with immunomodulation when switching from intravenous infliximab in inflammatory bowel disease A multicentre, randomised withdrawal trial PHASE4 Recruiting Kings Health Partners Crohn's disease and ulcerative colitis Digestive… The intervention is the withdrawal of immunomodul… Details
NCT05456776 Azathioprine Linked With Impaired Intestinal Epithelial Postoperative Regeneration in Crohn's Disease Not Available Not recruiting Centre of Postgraduate Medical Education None None Details
NCT04761952 N-3 Polyunsaturated Fatty Acids Prevent Postoperative Recurrence of Crohn's Disease:a Prospective Randomized Controlled Trial Not Available Not recruiting Sixth Affiliated Hospital, Sun Yat-sen University Inflammatory Bowel Diseases;Crohn Disease;Polyuns… Drug: azathioprine;Drug: infliximab;Drug: N-3 Pol… Details
EUCTR2019-002942-19-DK NORDTREAT_The Nordic IBD treatment strategy trial a randomized controlled trial of access to a protein profile_ PHASE4 Not Recruiting Region ebro l Crohn's disease and Ulcerative colitis MedDRA ve… Trade Name: Remicade Infliximab Pharmaceutical Fo… Details
DRKS00013246 6-TGN levels (azathioprine drug monitoring) and markers of mucosal healing in patients with inflammatory bowel disease Not Available Not Recruiting MHH OE6810 K50 K51;Crohn disease [regional enteritis];Ulcer… Group 1: Patients with IBD and azathioprine monot… Details
EUCTR2016-004112-35-SE Low-dose azathioprine and allopurinol- versus azathioprine monotherapy in patients with Inflammatory Bowel Disease: An investigator-initiated, open, multicentre, parallel-arm, randomized controlled trial __A SOIBD (The Swedish Organisation for the study of Inflammatory Bowel Diseases) study __ PHASE4 Authorised SOIBD (The Swedish Organisation for the study of Inflammatory Bowel Diseases) Patients with inflammatory bowel diseae (Ulcerati… Trade Name: Imurel Product Name: Azathioprine Pro… Details
ChiCTR-OOC-17010617 Study on the relationship between TPMT and NUDT15 gene polymorphism and azathioprine-induced adverse reactions in patients with inflammatory bowel disease Not Available Recruiting Xiangya Hospital, Central South University Inflammatory Bowel Disease Two cohorts:azathioprine treatment; Details
NCT02929706 Effectiveness of Thiopurine Dose Optimization by NUDT 15 R139C on Reducing Thiopurine-induced Leucopenia in Inflammatory Bowel Disease Not Available Not recruiting Sixth Affiliated Hospital, Sun Yat-sen University Thiopurine-induced Leukopenia Genetic: Pre-genotype NUDT15 and optimize azathio… Details
EUCTR2016-000522-18-FR Risk stratified randomized controlled trial in paediatric Crohn Disease: Methotrexate versus azathioprine or adalimumab for maintaining remission in patients at low or at high risk for aggressive disease course, respectively a treatment strategy - REDUCE-RISKincd-PIBD-TRIAL PHASE4 Not Available PIBDNet Crohn disease;Therapeutic area: Diseases [C] - Di… Product Name: humira Pharmaceutical Form: Solutio… Details
ACTRN12613001347752 A randomized controlled trial of patients with IBD attending specialist clinics comparing de novo combination allopurinol and thiopurine versus thiopurine and placebo (ie standard practice) in terms of objective and clinical outcomes at six months PHASE3|PHASE4 Recruiting Eastern Health Inflammatory Bowel Disease; Inflammatory Bowel D… De novo combination therapy with allopurinol 100m… Details
EUCTR2013-001503-37-DK Effect of low-dose Azathioprine and Allopurinol compared to Azathioprine on clinical outcomes in Inflammatory Bowel Disease PHASE3 Not Recruiting Marianne Kiszka-Kanowitz Inflammatory Bowel Disease, (Ulcerativ colitis, C… Trade Name: Imurel Pharmaceutical Form: Tablet IN… Details
ACTRN12611000363987 The Triple A (Adjunctive Allopurinol and Azathioprine) Study: Use of Ajunctive Allopurinol in Azathioprine/6-Mercaptopurine Non-responders to Optimize 6-Thioguanine Nucleotide Production and Improve Clinical Outcomes in Patients with Inflammatory Bowel Disease (IBD). PHASE3|PHASE4 Not Recruiting The Alfred Hospital Inflammatory Bowel Disease (IBD); Inflammatory B… Eligible IBD patients will be randomly allocated … Details
NL-OMON22783 Long term hepatotoxicity of azathioprine, 6-mercaptopurine and 6-thioguanine in inflammatory bowel disease. Not Available Not Recruiting Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands Inflammatory bowel disease, azathioprine, 6-merca… 1. Liver biopsy; 2. Venapuncture; 3. Abdominal … Details

Disease IDDisease NameDefinitionCategoryRelated DrugsMechanism
No data available

Strategy IDTherapeutic StrategySynonymsRelated DrugsMechanism
S02 Immunosuppression Classic immunosuppressive drugs azathioprine; 6-mercaptopurine; methotrexate; ciclosporin-A; tacrolimus Ciclosporin-A and tacrolimus bind to specific intracellular… Details

Economic impact of combination therapy with infliximab plus azathioprine for dr…

PMID: 22626508
Year: 2013
Relationship Type: Treatment Score: 9.1

BACKGROUND: Combination therapy with infliximab (IFX) and azathioprine (AZA) is significantly more effective for treatment of active Crohn's disease …

A case of therapy-related myeloid neoplasm in a patient with Crohn's disease tr…

PMID: 22572218
Year: 2012
Relationship Type: Treatment Score: 9.1

Acute leukaemia (AL) has been observed in association with Crohn's disease (CD) notably in patients treated with azathioprine (AZA), which is an immu…

Gene polymorphisms involved in manifestation of leucopenia, digestive intoleran…

PMID: 22535280
Year: 2012
Relationship Type: Treatment Score: 9.1

BACKGROUND: Approximately 10-28 % of patients experience adverse drug reactions related to treatment with thiopurines. The most serious reaction is m…

Oral squamous cell carcinoma in a Crohn's disease patient taking azathioprine: …

PMID: 22464812
Year: 2012
Relationship Type: Association Score: 9.1

Thiopurines are widely used for remission maintenance and post-operative recurrence prevention in Crohn's disease. The increased risk of cancer in tr…

Initiating azathioprine for Crohn's disease

PMID: 22330233
Year: 2012
Relationship Type: Treatment Score: 9.1

Azathioprine (AZA) and 6-mercaptopurine are therapeutic options for patients with moderate to severe inflammatory Crohn's disease. AZA has both a com…

Azathioprine hypersensitivity presenting as sweet syndrome in a child with ulce…

PMID: 22253154
Year: 2011
Relationship Type: Treatment Score: 9.1

Sweet syndrome is a cutaneous lesion characterized by tender, red inflammatory nodules or papules. We describe a pediatric case of Sweet syndrome pre…

Safety of azathioprine use during pregnancy

PMID: 22170192
Year: 2011
Relationship Type: Association Score: 9.1

QUESTION: Quite a few of my female patients with rheumatic diseases and inflammatory bowel disease are using azathioprine. They are afraid to take a …

A pharmacogenetics study of TPMT and ITPA genes detects a relationship with sid…

PMID: 21961091
Year: 2011
Relationship Type: Treatment Score: 9.1

BACKGROUND AND AIMS: Pharmacogenetic studies in inflammatory bowel diseases (IBD) are mainly focused on genes involved in the metabolism of Azathiopr…

Tolerance and efficacy of azathioprine in pediatric Crohn's disease

PMID: 21910176
Year: 2011
Relationship Type: Adverse Effect Score: 9.1

BACKGROUND: Thiopurines are considered first-line immunomodulators for the prevention of relapse in moderate to severe pediatric Crohn's disease (CD)…

Thiopurine methyl-transferase activity and azathioprine metabolite concentratio…

PMID: 21722149
Year: 2011
Relationship Type: Treatment Score: 9.1

BACKGROUND: Low thiopurine-methyl-transferase (TPMT) activity and high 6-thioguanine-nucleotide (6TGN) concentrations have been linked to therapeutic…

Azathioprine and mercaptopurine: lymphoma

PMID: 21648178
Year: 2011
Relationship Type: Treatment Score: 9.1

Prospective follow-up for a median of 35 months of a French cohort of 19 486 patients with inflammatory bowel disease showed a nearly 4-fold increase…

Association between adverse effects under azathioprine therapy and inosine trip…

PMID: 21544018
Year: 2011
Relationship Type: Treatment Score: 9.1

BACKGROUND: Inosine triphosphate pyrophosphatase (ITPA) catalyzes the pyrophosphohydrolysis of inosine triphosphate to inosine monophosphate. Recentl…

Recurrent atrial fibrillation in a patient with ulcerative colitis treated with…

PMID: 21496410
Year: 2011
Relationship Type: Treatment Score: 9.1

We present a clinical case report regarding recurrent atrial fibrillation in a patient with ulcerative colitis treated with azathioprine. Atrial fibr…

Relapse rate following azathioprine withdrawal in maintaining remission for Cro…

PMID: 21476031
Year: 2011
Relationship Type: Treatment Score: 9.1

BACKGROUND: The duration of use of azathioprine (Aza) and 6-mercaptopurine (6-MP) for maintaining remission for Crohn's disease is debatable. AIM: To…

Evidence for a functional genetic polymorphism of the Rho-GTPase Rac1. Implicat…

PMID: 21372752
Year: 2011
Relationship Type: Treatment Score: 9.1

BACKGROUND: Adverse effects of thiopurine drugs occur in 15-28% of patients and the majority is not explained by thiopurine-S-methyltransferase defic…

Pregnancy after azathioprine therapy for ulcerative colitis in a woman with aut…

PMID: 21367409
Year: 2011
Relationship Type: Treatment Score: 9.1

OBJECTIVE: To present a case of fertility restored by azathioprine treatment in a woman with autoimmune premature ovarian failure, Addison's disease,…

Mucosal healing with methotrexate in Crohn's disease: a prospective comparative…

PMID: 21235604
Year: 2011
Relationship Type: Treatment Score: 9.1

BACKGROUND: Mucosal healing has become a new therapeutic goal in Crohn's disease and can be achieved with azathioprine (AZA) or biologics. Methotrexa…

Impact of azathioprine and tumour necrosis factor antagonists on the need for s…

PMID: 21228429
Year: 2011
Relationship Type: Treatment Score: 9.1

OBJECTIVE: The aim of the study was to assess whether azathioprine and antitumour necrosis factor (TNF) treatment decrease the long-term need for sur…

Allopurinol might improve response to azathioprine and 6-mercaptopurine by corr…

PMID: 21175793
Year: 2011
Relationship Type: Treatment Score: 9.1

BACKGROUND AND AIM: Allopurinol potentiates azathioprine and 6-mercaptopurine (6-MP) by increasing 6-thioguanine nucleotide (6-TGN) metabolite concen…

Change in hematologic indices over time in pediatric inflammatory bowel disease…

PMID: 21171667
Year: 2010
Relationship Type: Adverse Effect Score: 9.1

Azathioprine leads to changes in mean corpuscular volume (MCV) and white blood cell (WBC) indices reflecting efficacy or toxicity. Understanding the …

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