azathioprine / Generic mfg. - LARVOL DELTA

In-silico, in-vitro, and proteomics analyses on repurposed drugs in targeting the small GTPase, Rho subfamily protein (Rho GTPase), and putative Rho GTPase-activating protein (RhoGAP) of Giardia lamblia. (PubMed, J Genet Eng Biotechnol) - "Giardia lamblia is a globally prevalent protozoan responsible for Giardiasis, an intestinal disease commonly treated with nitroimidazoles such as metronidazole, tinidazole, and albendazole...Target sequence analysis revealed Dextromethorphan and Azathioprine as candidate Rho GTPase inhibitors, and Imatinib, Dasatinib, and Ponatinib as RhoGAP inhibitors...These findings highlight RhoGAP as a promising therapeutic target in G. lamblia, with Dasatinib showing potential as a repurposed treatment for Giardiasis. Proteomic data are publicly available in the MASSIVE database under identifier MSV000097321."

Journal • Preclinical • Gastrointestinal Disorder • Infectious Disease

Thiopurine pharmacogenomic landscape in India: TPMT and NUDT15 allele frequencies (ASH 2025) - "Thiopurines—such as azathioprine, mercaptopurine, and thioguanine—are commonly used in hematology as immunosuppressants and chemotherapeutic agents. We also identified rare, potentially deleterious TPMT variants that are absent or underrepresented in global reference datasets, underscoring the value of population-specific pharmacogenomic profiling. Our findings support pre-treatment NUDT15 genotyping (and TPMT where indicated) with genotype-informed dose adjustment and early monitoring to reduce myelosuppression-related treatment interruptions."

Biomarker • NUDT15

Risk of lymphoma with antimetabolite and biologic combinations: A pharmacovigilance analysis using the FDA adverse event reporting system database (ASH 2025) - "Our study compared combinations of antimetabolites—such asmethotrexate (MTX), mercaptopurine (6-MP), and azathioprine (AZA)—with anti-TNF agents includinginfliximab, adalimumab, certolizumab, and golimumab, to determine which regimens were most stronglyassociated with lymphoma. Clinicians should carefully weigh the risks and benefits of combination immunosuppressivetherapy, especially when prescribing infliximab with MTX or 6-MP, given the observed synergistic increasein risk for lymphoma."

Adverse events • Hematological Malignancies • Immunology • Lymphoma • ROR1

Preliminary clinical experience with mesenchymal stromal cells in autoimmune hemolytic anemia: A Case series in two dogs and one cat (ASH 2025) - "While first-line therapy typically consists of corticosteroids in combination with adjunctive immunosuppressiveagents such as cyclosporine or azathioprine, a subset of patients fails to achieve sustained clinicalremission. However, further controlled clinical trials arewarranted to confirm efficacy, optimize dosing regimens, and comprehensively evaluate long-term safetyprofiles. Given the shared pathophysiology of AIHA across species, these data may provide importanttranslational insights relevant to the development of MSC-based therapies for human autoimmunehemolytic conditions."

Clinical • Stroma • Anemia • Autoimmune Hemolytic Anemia • Hematological Disorders • Immunology • Infectious Disease • CD44 • ITGB1 • THY1

Propensity score matching analysis comparing the efficacy and long-term outcomes of belumosudil to the best available treatment as a historical control, used as second-line therapy or beyond for chronic GVHD after steroid failure. (ASH 2025) - "Treatment included prednisone in 284 (92.5%),mycophenolate in 145 (47.2%), azathioprine (AZA) in 144 (46.9%), a calcineurin inhibitor in 54 (17.6%),hydroxychloroquine in 51 (16.6%), extracorporeal photopheresis in 20 (6.5%), and rituximab in 10 (3.3%).A propensity score was calculated from the following unbalanced clinical factors: age (≥60 vs. <60), GvHDseverity (severe vs. mild/moderate), HCT-CI score (≥3 vs. <3), and treatment line (≥4th vs. <4th). The BEL group showed 72.0% [55.0–83.4] 12 months' FFS rate vs25.3% [10.6–43.1] for BAT (p<0.001), whereas 12 months' OS rates were 92.1% [77.3–97.4] and 88.4%[60.8–97.0] (p=0.317), respectively.Both univariate (UVA) and multivariate analysis (MVA) (BEL vs. BAT, HCT-CI ≥3, severe cGvHD, age ≥ 60,and previous acute GvHD) for FFS confirmed BEL superiority over BAT (hazard ratio (HR) 0.288 [0.155–0.535], p<0.001; no differences for the other factors). For OS, UVA showed that BEL had a trend for ahigher OS..."

Clinical • Acute Graft versus Host Disease • Chronic Graft versus Host Disease • Graft versus Host Disease • Immunology

A US real-world analysis of demographics, transplant patterns, and survival outcomes in posttransplant lymphoproliferative disorder (PTLD) (ASH 2025) - "Other agents includedprednisone (6.2%), cyclosporine (5.8%), sirolimus (5.8%), dexamethasone (4.8%), azathioprine (3.1%),methylprednisolone (1.9%), everolimus (0.7%), ibrutinib (0.6%), ruxolitinib (0.6%), mycophenolate(0.3%), basiliximab (0.2%), and thymoglobulin (0.1%).Extranodal, bone marrow, and CNS involvement were present in 29.5%, 1.9%, and 1.8% of cases,respectively...Median OSfor heart transplant recipients was 2730 days, and for those who underwent HSCT, 2643 days.Regarding treatment, only 10 patients received bispecific antibodies (glofitamab, epcoritamab, ormosunetuzumab) and only 23 patients received CAR-T therapy. This study represents one of the largest real-world analyses of PTLD in adult patients inthe US, utilizing the TriNetX dataset spanning over three decades. This study represents one of the largest real-world analyses of PTLD in adult patients inthe US, utilizing the TriNetX dataset spanning over three decades. Improvement in OS in more recentyears..."

Clinical • Post-transplantation • Real-world • Real-world evidence • Bone Marrow Transplantation • Epstein-Barr Virus Infections • Hematological Malignancies • Hodgkin Lymphoma • Lymphoma • Solid Organ Transplantation • Transplantation

Real world outcomes of patients with cold agglutinin disease (ASH 2025) - "The median number of 1 (range 0-7) lines of therapy for CAD were administered.Rituximab monotherapy ± plasma exchange were most frequently employed (n=31) and, along withdexamethasone-rituximab-cyclophosphamide (n=7), achieved the highest response rates of 71% (22/31and 5/7, respectively). Bortezomib combinations yielded a 67% response (2/3), as did R-CHOP-likecombinations (4/6). Complement inhibitors were used in 13 patients with a 61% response rate (8/13).Bendamustine-rituximab, BTKi, and daratumumab each demonstrated response rates of 57% (4/7 each),while venetoclax produced a 50% response (1/2). Among 54 patients with CAD, many required multiple treatment regimens. Response rates exceeded 50%in the majority with best responses with traditional rituximab-based therapies and efficacy with cloneand complement-directed therapy."

Clinical • IO biomarker • Real-world • Real-world evidence • Autoimmune Hemolytic Anemia • Cardiovascular • Complement-mediated Rare Disorders • Hematological Disorders • Hematological Malignancies • Lymphoma • Lymphoplasmacytic Lymphoma • Non-Hodgkin’s Lymphoma • Thrombosis • Waldenstrom Macroglobulinemia

Prevalence and demographics of autoimmune hemolytic anemia in the United States (ASH 2025) - "Annual prevalence was stratified by age group, sex,and prescription fill for an AIHA-related treatment (systemic steroids, immunosuppressants[azathioprine, mycophenolate, cyclosporin, cyclophosphamide, danazol, bortezomib, rituximab],splenectomy) in the calendar year. AIHA prevalence in this study was consistent with estimates from European countries andhas been increasing in recent years, providing evidence of consistent disease epidemiology across severalgeographies."

Anemia • Autoimmune Hemolytic Anemia • Hematological Disorders • Immunology

Real-world effectiveness and safety of fostamatinib in difficult-to-treat patients: Results of a three-year registry in France. (ASH 2025) - "Seventy-height percent ofpatients had been exposed to eltrombopag, 74.4% to romiplostim, 86.0% to rituximab, 48.8% tomycopenolate or azathioprine, and 28.0% were splenectomized. Fostamatinib was used in previously very heavily treated patients, with response rates of44.0% at M3 and of 20.0% at M24. Combination therapy with TPO-RA is an option to consider in thispopulation. No new safety signal was observed."

Clinical • Real-world • Real-world effectiveness • Real-world evidence • Hematological Malignancies • Immune Thrombocytopenic Purpura • Immunology • Infectious Disease • Lymphoma • Musculoskeletal Diseases • Myocardial Infarction • Neutropenia • Pulmonary Arterial Hypertension • Thrombocytopenia • Thrombocytopenic Purpura • Thrombosis

Daratumumab for immune-mediated thrombotic thrombocytopenic purpura (iTTP): Results from the international, multicenter darttp study (ASH 2025) - "Patients had received a median of 3 (IQR 2)previous IST, including rituximab (100%), bortezomib and mycophenolate (25% each), cyclosporine andcyclophosphamide (20% each), azathioprine (15%), vincristine (10%), obinutuzumab, ofatumumab, andsplenectomy (5% each). Seventeen patients received daratumumab in the remission phase (i.e., forADAMTS13 relapse or intolerance to other IST), while 3 during an acute episode (plasma-based therapyand caplacizumab ongoing in 3 and 2 patients, respectively)...Disease duration, previous IST used, daratumumab schedule, ordemographics did not correlate with response or its duration...A patient not receiving acyclovir had a grade 2 zoster skininfection 3 months after her last daratumumab infusion. in this study, daratumumab warranted rapid ADAMTS13 remission in 75% of iTTP patientsrefractory or intolerant to rituximab and other conventional IST... in this study, daratumumab warranted rapid ADAMTS13 remission in 75% of iTTP patientsrefractory..."

Clinical • Cardiovascular • Dermatology • Hematological Disorders • Herpes Zoster • Thrombocytopenic Purpura • CD20

Severe hemolysis flare of refractory warm hemolytic anemia with positive complement component C3d responsive to iptacopan with cyclophosphamide and prednisone (ASH 2025) - "All patients had received at least two prior therapies, including but not limited to steroids,IVIG, rituximab, tacrolimus and azathioprine without achieving a good response...In addition, twopatients (13.33%) had a history of bortezomib treatment, and another two patients (13.33%) hadreceived azathioprine therapy... Refractory wAIHA patients achieved good therapeutic efficacy after treatment with Iptacopancombined with cyclophosphamide and prednisone. Our clinical practice will provide a new potentialapproach to the treatment of refractory wAIHA."

Anemia • Autoimmune Hemolytic Anemia • Hematological Disorders • Hematological Malignancies • Immunology • Inflammatory Arthritis • Lupus • Lymphoma • Systemic Lupus Erythematosus

Hematological symptom burden and treatment patterns in patients with IgG4-related disease: A real-world, multicenter retrospective analysis (ASH 2025) - "The most used agents includedrituximab (6%), azathioprine (6%), mycophenolate mofetil (5%), and methotrexate (3%).In this large, real-world cohort of patients with IgG4-RD, hematologic manifestations were observed inover one-fifth of patients and were associated with a numerically higher mortality rate.Lymphadenopathy was the most common hematologic feature. In this large, real-world cohort of patients with IgG4-RD, hematologic manifestations were observed inover one-fifth of patients and were associated with a numerically higher mortality rate.Lymphadenopathy was the most common hematologic feature. Despite the widespread use ofcorticosteroids, a substantial proportion of patients required steroid-sparing agents. These findingshighlight the hematologic complexity of IgG4-RD and underscore the need for multidisciplinarymanagement and prospective studies focused on hematologic outcomes."

Real-world • Real-world evidence • Retrospective data • Cardiovascular • Eosinophilia • Hematological Malignancies • Hepatology • Hypertension • Inflammation • Monoclonal Gammopathy

Double or triple therapy in newly diagnosed immune thrombocytopenia: Improving outcomes from the west-central Mexican experience. (ASH 2025) - "Treatment consisted of oral or IV dexamethasone 40mg daily for 4 days every 21 days for two cycles; eltrombopag 50 mg daily for 28 days, suspended ifplatelet counts rise above 400x109/L; and azathioprine 2 mg/kg/day for 42 days in DEA arm. With this latter group the DOR was better at 180 and maintained at 360 days.The cornerstone in the treatment has been with steroids, but differences in type of steroid and number ifcycles remain unanswered, even more with combinations, and the Introduction of new agents (BloodReviews 2025,101300). Multicentric clinical trials are needed to evaluate the combined therapy that willbring long lasting complete remissions or even cure in the first line of therapy."

Immune Thrombocytopenic Purpura • Immunology • Infectious Disease • Thrombocytopenia • Thrombocytopenic Purpura

Calcineurin inhibitors reduce risk of MGUS progression to multiple myeloma in immunosuppressant users: A retrospective multi-institution cohort study (ASH 2025) - "To ensure maximal consistency across the studied population,both the exposure group and the control group had received at least one of the following IST—azathioprine, leflunomide, cyclophosphamide, methotrexate, sulfasalazine, or mycophenolate mofetil—within 1 year prior to, or any time after, the initial diagnosis of MGUS but before any diagnosis of MM.Patients in CNi group were defined by additional CNi exposure (excluding topical and ophthalmic route)within the same time window, whereas control had never received CNi. These findings support thehypothesis that dampening immune activation may lower the risk of malignant transformation in MGUS.Clinically, this study alleviates concerns regarding the potential oncogenic risks of cytotoxic T cellsuppression in patients with coexisting autoimmune disorders and MGUS. Furthermore, it raises thepotential role of T cell inhibitors as one of the interventions to prevent MGUS progression in broaderpatient populations, warranting..."

Retrospective data • Amyloidosis • Chronic Kidney Disease • Hematological Malignancies • Immunology • Monoclonal Gammopathy • Multiple Myeloma • Nephrology • Ophthalmology • Renal Disease • Solid Organ Transplantation • CD8 • GZMB

Heterogeneity of treatment regimens and related health resource use in managing patients with waiha: A US multi-database retrospective observational Study (ASH 2025) - "Patients on treatment were defined by use of oral corticosteroids (OCS), immunosuppressants(IST) (including azathioprine, mycophenolate mofetil, cyclosporine, cyclophosphamide, or tacrolimus) orrituximab. No changes in rescue treatments, and anincrease in blood transfusions after rituximab infusion suggest treatment gaps remain. Analysis revealsheterogeneity in rituximab dosing patterns including high deviation from standard dosing practices; thisvariance from published expert opinion along with common use of rescue therapies suggests continuedneed for standardized guidelines and development of targeted therapies in wAIHA."

Heterogeneity • Observational data • Retrospective data • Autoimmune Hemolytic Anemia • Hematological Malignancies • Immunology • Solid Tumor

Anti-CD19 chimeric antigen receptor T-cell therapy for patients with non-Hodgkin's lymphoma and concurrent autoimmune disease (ASH 2025) - "methotrexate, hydroxychloroquine (HCQ),azathioprine); 9 required biologic/targeted DMARD (ex. adalimumab, etanercept, risankizumab,infliximab, rituximab).DMARDs were weaned prior to CART however 9 pts (37.5%) remained on AID tx at the time of cellcollection, including HCQ (n=4), sulfasalazine/mesalamine (n=2), and 1 each of prednisone, colestipol,sulfasalazine, and apremilast... In this single center study of pts receiving CART for NHL we found no difference in responserates nor survival outcomes in pts with or without AID and therefore propose that AID should notpreclude the use of CART. Lower severity of ICANS was seen in AID pts, though additional study withlarger cohorts is required. The majority of pts were able to taper off AID tx prior to CART, while HCQ wasable to be safely continued throughout CART collection with no apparent effect on CART efficacy."

CAR T-Cell Therapy • Clinical • Ankylosing Spondylitis • B Cell Non-Hodgkin Lymphoma • CNS Disorders • Dermatology • Dermatomyositis • Gastroenterology • Hematological Disorders • Hematological Malignancies • Immunology • Inflammatory Arthritis • Lymphoma • Myasthenia Gravis • Myositis • Non-Hodgkin’s Lymphoma • Psoriasis • Rheumatoid Arthritis • Rheumatology • Seronegative Spondyloarthropathies

P062 National clinical reaudit on managing adults with bullous pemphigoid 2024: shifting clinical practices. (PubMed, Br J Dermatol) - "The use of doxy-cycline as first-line treatment rose significantly (83.8% in 2024 vs. 50.7% in 2018, P < 0.001), while azathioprine was less frequently prescribed, reflecting a shift towards mycophenolate mofetil. The continued reliance on oral corticosteroids despite increased doxycycline use suggests caution in transitioning to safer options. These findings emphasize the need for updated BP management guidelines and targeted educational initiatives to support best practice."

Journal • Bullous Pemphigoid • Dermatology • Dermatopathology • Immunology • Infectious Disease • Novel Coronavirus Disease • Osteoporosis • Rheumatology

BI24 A case of refractory pyoderma gangrenosum successfully treated with upadacitinib. (PubMed, Br J Dermatol) - "The patient also had enteropathic arthritis, initially controlled with infliximab and azathioprine...Initial treatments were unsuccessful, including wound dressings, topical and systemic corticosteroids (intravenous methylprednisolone), topical tacrolimus and antibiotics. Ciclosporin was introduced when she did not respond to escalated doses of infliximab...This case highlights the importance of collaborating with other specialties regarding alternative treatments that are not available for dermatology conditions. Further studies are needed to evaluate the efficacy of Janus kinase inhibitors in PG."

Journal • Crohn's disease • Dermatology • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Immunology • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Pain • Pyoderma Gangrenosum • Rheumatoid Arthritis • Rheumatology

P088 Janus kinase inhibitor treatment in coexisting atopic dermatitis and irritable bowel disease: real-world experience and therapeutic outcomes. (PubMed, Br J Dermatol) - "Despite the apparent efficacy treating IBD in this series, only two of seven patients (29%) achieved satisfactory cutaneous response to JAKi monotherapy, contrasting with established efficacy data in isolated AD. These findings raise questions about underlying disease mechanisms in this phenotype, warranting further investigation.TableTreatment of seven patients with atopic dermatitis (AD) and irritable bowel disease (IBD) with Janus kinase inhibitors (JAKis)Age (years)Primary indicationBefore JAKi treatmentOn JAKi treatmentDisease statusAD treatmentIBD treatmentJAKi therapyOutcomes50ADEASI 54; UC controlledNoneGuselkumab (stopped)Upadacitinib 24 months (ongoing)EASI 75 achieved (5.1); UC remission22AD, CDEASI 41; CD activeMethotrexate (stopped)Infliximab (stopped)Upadacitinib 4 months (ongoing)EASI 75 achieved (7.4); CD remission29ADEASI 13; UC controlledNoneAZA, allopurinol (stopped)Upadacitinib 8 months (ongoing)EASI 10.3; added methotrexate (6 months), switched to..."

Journal • Real-world evidence • Alopecia • Atopic Dermatitis • Crohn's disease • Dermatitis • Dermatology • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Herpes Zoster • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis • Varicella Zoster

PA17 A challenging case of refractory childhood pemphigus vulgaris. (PubMed, Br J Dermatol) - "He commenced oral prednisolone 20 mg daily, but continued to develop new blisters with 11-kg weight loss due to limited oral intake...Mycophenolate mofetil (MMF) (10 mg kg-1 twice daily) was added, leading to disease stabilization enabling prednisolone tapering...On increasing MMF to 20 mg kg-1 twice daily, disease remission was eventually achieved, and azathioprine and prednisolone were stopped...Almost all cases achieved complete or partial remission after rituximab, mostly without relapse and only minor side-effects. A wide range of dosing regimens were used. Our case highlights the challenges in managing refractory PV in this age group."

Journal • Cushing’s Disease • Dermatology • Endocrine Disorders • Immunology • Oncology • Pemphigus Vulgaris • Steven-Johnson Syndrome

P118 A retrospective analysis of rituximab prescribing for 38 patients with pemphigus over a 10-year period in a tertiary immunobullous clinic: should we be using rituximab as first-line therapy for moderate and severe pemphigus? (PubMed, Br J Dermatol) - "Second-line treatment was with mycophenolate mofetil in 76% (n = 29), azathioprine in 7% (n = 3) and dapsone in 5% (n = 2). Third-line treatments included azathioprine, dapsone and methotrexate...Of these, 85% were still taking prednisone and/or mycophenolate mofetil at 6 months, with further reduction and cessation of these medications documented over a longer timeframe...Our real clinic findings highlight the management of patients with severe or recalcitrant pemphigus. The results are corroborated by the increasing body of convincing medical evidence suggesting that earlier administration of rituximab for pemphigus is both safer and more efficacious than standard therapy and make a case for earlier use of rituximab in this challenging cohort."

Journal • Retrospective data • Dermatology • Immunology • Pemphigus Vulgaris

SG01 Naltrexone: not a one-trick pony for opioid overdose. The use of naltrexone to successfully treat severe Hailey-Hailey disease. (PubMed, Br J Dermatol) - "In 2022, acitretin was commenced and uptitrated to 25 mg once daily...Other immunosuppressive agents such as methotrexate, ciclosporin and azathioprine have been described in the literature with varying efficacy...Naltrexone is postulated to work due to analgesic and anti-inflammatory effects. It is a well-tolerated treatment for severe HHD that has drastically improved both our patient's skin and his quality of life."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Dermatology • Genetic Disorders • Oncology • Pain • IL6 • TLR4

P040 Clinical features, treatment and treatment response of 24 patients with epidermolysis bullosa acquisita. (PubMed, Br J Dermatol) - "All patients were treated initially with oral prednisolone and some patients required oral dapsone (n = 20), intravenous corticosteroids (n = 11), mycophenolate mofetil (n = 19) and azathioprine (n = 7). Overall, 63% (n = 15) of patients were treated with intravenous immunoglobulin (IVIG) and 63% (n = 15) with rituximab...In conclusion, the treatment of EBA can be challenging, and most patients in this series required combination treatment with corticosteroids, dapsone and an intravenous immunosuppressant. The treatment-refractory nature of the disease is also reflected by the high proportion of patients requiring rituximab, and 25% of patients having ongoing active disease despite maximal therapy."

Journal

BI16 The COAST (Contemporary Outcomes After cutaneous SCC in Transplant recipients) study: final results and implications for management following the first cutaneous squamous cell carcinoma in kidney transplant recipients. (PubMed, Br J Dermatol) - "Within 6 months of the first cSCC, 21% of KTRs were using topical chemoprevention (mainly 5-fluorouracil cream), 6% started systemic chemoprevention (acitretin or nicotinamide) and 5% used destructive therapies...Immunosuppression reduction strategies varied both within and between centres and were more frequently undertaken in patients with high-risk CSCC or in those on azathioprine (P = 0.01)...These data highlight the urgent need for prospective studies to identify optimal management of KTR following a first cSCC. Here we propose a risk stratification approach that may be used to guide prevention strategies."

Journal • Retrospective data • Dermatology • Non-melanoma Skin Cancer • Oncology • Solid Organ Transplantation • Squamous Cell Carcinoma • Squamous Cell Skin Cancer • Transplantation

P006 An evaluation of digital mole mapping for patients at high risk of melanoma. (PubMed, Br J Dermatol) - "Ten cases (average age 54.4 years) were immunosuppressed, with a range of aetiologies from lymphoma (n = 3) to azathioprine for inflammatory bowel disease (n = 2)...Because 84% of melanomas were detected at follow-up, and by Breslow thickness they were uniformly thin, this supports the effectiveness of the follow-up approach here. This evaluation of individuals with numerous melanocytic naevi supports this approach as an effective use of resources."

Journal • Retrospective data • Dermatology • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Inflammatory Bowel Disease • Lymphoma • Melanoma • Oncology • Skin Cancer • Solid Tumor • BAP1 • CDK4 • CDKN2A • POT1