Off-Label Use of Azathioprine in Dermatology

A systematic review points to the need for long-term registries to ensure evidence-based healthcare decision making in dermatology.

Since the early days of my practice, I have used azathioprine in patients with recalcitrant dermatoses, including blistering diseases, lupus erythematosus, atopic dermatitis, and vasculitis, and have often noted a steroid-sparing effect.

These authors performed a systematic review of the literature for trials of off-label azathioprine use for different dermatologic indications. From 3870 citations, they selected for analysis 43 randomized trials and case series involving six or more patients. They found high-level evidence to support the use of azathioprine in atopic dermatitis; moderate-level evidence for use in bullous pemphigoid, type 1 leprosy reactions, airborne contact dermatitis, and chronic actinic dermatitis; and low-level evidence …

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)