I have recently (a little over a year ago) run ITCM in an Azure environment so I can share some of my experience:
In short, I would not recommend running any medium to large ITCM environment in Azure without careful evaluation of performance and costs.
Given my background of 22 years at CA most of which were spent implementing ITCM for customers, therefore having experienced ITCM performance in many different environments, I believe I am reasonably qualified to evaluate the performance characteristics of ITCM in the Azure environment as compared to on-premise environments whether physical or virtual. While it did function, the experience was far from ideal. As a very data-transfer intensive application I don't believe ITCM is a good candidate to be implemented fully in the cloud. Smaller environments may work reasonably well but as your Agent population increases, your performance will decline sharply and this will likely result in higher costs and lower satisfaction.