Long-term maintenance therapy with azathioprine in systemic lupus erythematosus

Arthritis Rheum. 1975 Jan-Feb;18(1):27-34. doi: 10.1002/art.1780180106.


One hundred ten patients with systemic lupus erythematosus (SLE) were classified into two groups, patients with central nervous system (CNS) or severe renal disease (usually associated with a poor prognosis) and patients without these manifestations, to define criteria for azathioprine therapy. Fifty-four of 68 patients with a poor prognosis received azathioprine. Azathioprine-treated patients showed improved long-term survival (72% vs 29%, P less than .005) and fewer hospitalizations (0.24/patient-years vs 0.89/patient-years, P less than .001). Azathioprine therapy in 19 of 42 patients with a good prognosis was associated with fewer hospitalizations (.02/patient-years vs .17/patient-years, P less than .05), but no decrease in maintenace prednisone requirement. Progression from a good to a poor prognosis was less frequent (1 of 20 vs 11 of 34, P = less than .05) among azathioprine-treated patients. Toxicity of azathioprine was minimal. Azathioprine therapy is indicated in patients with CNS or severe renal disease, and in patients whose prognosis was good with frequent hospitalizations or a maintenance prednisone requirement greater than 15 mg/day.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Azathioprine / administration & dosage
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use*
  • Biopsy
  • Central Nervous System Diseases / drug therapy
  • Female
  • Hospitalization
  • Humans
  • Kidney Diseases / drug therapy
  • Kidney Diseases / mortality
  • Kidney Diseases / pathology
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / mortality
  • Male
  • Middle Aged
  • Nephrotic Syndrome / drug therapy
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Pregnancy
  • Prognosis
  • Time Factors


  • Azathioprine
  • Prednisone