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6-Thioguanine thera...
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Almer, SvenLinköpings universitet,Gastroenterologi och hepatologi,Hälsouniversitetet,Landstinget i Östergötland; Local Health Care Services in Central Östergötland; Department of Endocrinology and Gastroenterology; Närsjukvården i centrala Östergötland; Endokrin- och magtarmmedicinska kliniken
(författare)
6-Thioguanine therapy in Crohns disease-Observational data in Swedish patients
- Artikel/kapitelEngelska2009
Förlag, utgivningsår, omfång ...
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Elsevier BV,2009
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:liu-17514
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-17514URI
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https://doi.org/10.1016/j.dld.2008.07.314DOI
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https://lup.lub.lu.se/record/1404940URI
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Språk:engelska
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Sammanfattning på:engelska
Ingår i deldatabas
Klassifikation
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Background and aims: Adverse events (AE) leading to discontinuation or dose-reduction of thiopurine therapy (TP) occur in 9-28% of patients with inflammatory bowel disease. 6-Thioguanine (6-TG) has been proposed as an alternative treatment in patients intolerant for azathioprine (AZA), but some concerns have been raised about drug safety. Methods: We evaluated in a prospective manner the tolerance and efficacy of 6-TG in 23 Crohns disease (CD) patients (13 men, median age 41 (19-65) years) with prior intolerance (n = 18) or resistance (It = 5) to AZA and/or 6-mercaptopurine (6-MP). In addition, eight patients had tried mycophenolate mofetil. Seventeen patients (74%) had undergone intestinal resection, often several times. Results: Patients were treated with a median daily dose of 40 mg 6-TG (range 20-60) for 259 (15-2272) days. Seven of 13 patients (54%) with active disease went into remission after 8 (4-26) weeks. Sixteen patients (70%) experienced AE that lead to discontinuation (n=10) after 85 (15-451) days or dose reduction (n=6) after 78 (10-853) days. Ten of 18 patients (56%) with prior TP-intolerance discontinued 6-TG treatment due to AE compared to none of five patients with TP-resistance (p=0.046). Of 13 patients that tolerated 6-TG, eight discontinued the drug due to therapeutic failure (n=5) or safety concerns (n=3). Eight patients (35%) continued treatment beyond 12 months. There was no significant difference in maximum thioguanine nucleotide levels between patients with AE leading to discontinuation/dose reduction and patients without AE, 652 (99-2488) vs. 551 (392-1574) pmol/8 x 10(8) RBC; p=0.80. Conclusions: In this cohort of CD patients with severe disease failing traditional thiopurine treatment, a small fraction (22%) had long-term benefit of 6-TG-treatment. 6-TG therapy seems to offer a limited therapeutic gain for patients intolerant to both AZA and 6-MP and other treatment options should be considered.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Hjortswang, HenrikLinköpings universitet,Gastroenterologi och hepatologi,Hälsouniversitetet,Landstinget i Östergötland; Local Health Care Services in Central Östergötland; Department of Endocrinology and Gastroenterology; Närsjukvården i centrala Östergötland; Endokrin- och magtarmmedicinska kliniken(Swepub:liu)henhj44
(författare)
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Hindorf, UlfLund 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(Swepub:lu)med-uhi
(författare)
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Linköpings universitetGastroenterologi och hepatologi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Digestive and Liver Disease: Elsevier BV41:3, s. 194-2001590-86581878-3562
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