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Mercaptopurine trea...
Mercaptopurine treatment should be considered in azathioprine intolerant patients with inflammatory bowel disease
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- Hindorf, Ulf (author)
- Lund University,Lunds universitet,Medicin, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Hospital
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- Johansson, M. (author)
- Linköpings universitet,Institutionen för klinisk och experimentell medicin,Hälsouniversitetet
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- Eriksson, Anders, 1957 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine,Sahlgrens University Hospital
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- Kvifors, Eva, 1952 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine,Sahlgrens University Hospital
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- Almer, Sven (author)
- Östergötlands Läns Landsting,Linköpings universitet,Gastroenterologi och hepatologi,Hälsouniversitetet,Endokrin- och magtarmmedicinska kliniken US
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(creator_code:org_t)
- Wiley, 2009
- 2009
- English.
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In: Alimentary Pharmacology & Therapeutics. - : Wiley. - 1365-2036 .- 0269-2813. ; 29:6, s. 654-61
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Abstract
Subject headings
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- BACKGROUND: Adverse drug reactions are a significant reason for therapeutic failure during thiopurine treatment of inflammatory bowel disease. Some smaller series in this patient population have shown that a switch to mercaptopurine may be successful in many cases of azathioprine intolerance. AIM: To assess the long-term outcome of mercaptopurine treatment in a large patient population with azathioprine intolerance. METHODS: We identified 135 patients (74 women; median age 40 years) with Crohn's disease (n = 88) or ulcerative colitis (n = 47) and reviewed their medical records. RESULTS: A total of 70 patients (52%) tolerated mercaptopurine and were followed up for 736 (362-1080) days; 65 patients discontinued mercaptopurine due to adverse events after 25 (8-92) days. Mercaptopurine was tolerated in 71% (12/17) with hepatotoxicity and in 68% (13/19) with arthralgia/myalgia during azathioprine treatment. Previous abdominal surgery was more common in mercaptopurine intolerant patients [39/65 (60%) vs. 27/70 (39%); P = 0.02] and thiopurine methyltransferase activity was higher in mercaptopurine tolerant patients than in mercaptopurine intolerant patients [13.2 (11.4-15.3) vs. 11.8 (9.6-14.2) U/mL red blood cells; P = 0.04; n = 81]. CONCLUSIONS: A trial of mercaptopurine should be considered in azathioprine intolerance, as half of the patients tolerate a switch to mercaptopurine. Patients with hepatotoxicity or arthralgia/myalgia during azathioprine treatment might benefit more often than those with other types of adverse events.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- 6-Mercaptopurine/*therapeutic use
- Adult
- Azathioprine/*adverse effects
- Dose-Response Relationship
- Drug
- Drug Hypersensitivity
- Female
- Humans
- Immunosuppressive Agents/*therapeutic use
- Inflammatory Bowel Diseases/*drug therapy
- Male
- Middle Aged
- Treatment Outcome
- MEDICINE
Publication and Content Type
- ref (subject category)
- art (subject category)
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