Mercaptopurine and inflammatory bowel disease: the other thiopurine
Rev. esp. enferm. dig
; 109(1): 10-16, ene. 2017. tab, graf
Artigo
em Inglês
| IBECS
| ID: ibc-159209
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
Background:
Data about use and effectiveness of mercaptopurine in inflammatory bowel disease are relatively limited.Aims:
To assess the possible therapeutic indications, efficacy and safety of mercaptopurine as an alternative to azathioprine in inflammatory bowel disease.Methods:
Retrospective observational study in patients treated with mercaptopurine in a total cohort of 1,574 patients with inflammatory bowel disease.Results:
One hundred and fifty-two patients received mercaptopurine, 15.7% of these patients as an initial thiopurine, 5.3% after azathioprine failure, and 79% after azathioprine intolerance. In 52.6% of patients (n = 80), adverse effects of mercaptopurine occurred, resulting in withdrawal in 49 of them. Mercaptopurine was effective in 39% of cases (95% CI 31-48%). In the remaining patients, failure was due mainly to withdrawal due to side effects (55.1%) and therapeutic step-up (33.7%). The average total time of mercaptopurine exposure was 36 months (IQR 2-60). Myelotoxicitywith mercaptopurine was more common in patients with intermediate TPMT activity than in those with normal activity (p = 0.046).Conclusions:
In our setting, mercaptopurine is primarily used as a rescue therapy in patients with azathioprine adverse effects. This could explain its modest efficacy and the high rate of adverse effects. However, this drug is still an alternative in this group of patients, before a therapeutic step-up to biologics is considered (AU)RESUMEN
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Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Base de dados:
IBECS
Assunto principal:
Tioinosina
/
Doenças Inflamatórias Intestinais
/
Colite Ulcerativa
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Avaliação de Eficácia-Efetividade de Intervenções
/
Imunossupressores
Tipo de estudo:
Estudo de etiologia
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Estudo de incidência
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Estudo observacional
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Fatores de risco
Limite:
Adulto
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Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2017
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Universitario Ramón y Cajal/Spain
/
Hospital Universitario de Fuenlabrada/España