azathioprine + thalidomide

Azathioprine + thalidomide is a combination therapy used primarily for treating Crohn's disease patients who have lost response to azathioprine monotherapy. This combination leverages the immunosuppressive properties of both medications to induce clinical remission and maintain long-term steroid-free remission. Azathioprine is a prodrug of 6-mercaptopurine that interferes with DNA synthesis and inhibits T-cell function, while thalidomide inhibits tumor necrosis factor-alpha (TNF-α) production, modulates T-cell function, and has anti-angiogenic effects. The combination demonstrates synergistic effects, particularly in refractory Crohn's disease cases.