Incidence, risk factors and clinical course of thiopurine-induced liver injury in patients with inflammatory bowel disease.
Aliment Pharmacol Ther
; 22(9): 775-82, 2005 Nov 01.
Article
en En
| MEDLINE
| ID: mdl-16225485
ABSTRACT
BACKGROUND:
The incidence of thiopurine-induced hepatotoxicity in patients with inflammatory bowel disease varies in different studies.AIMS:
To assess the rate of thiopurine-induced liver toxicity in patients with inflammatory bowel disease; to determine the predictive factors and to characterize its clinical course and management.METHODS:
A cohort of 161 patients was prospectively followed for a median of 271 days. Hepatotoxicity was established when alanine transaminase or alkaline phosphatase plasma levels were greater than twice the upper normal limit.RESULTS:
Abnormal liver function was detected in 21 patients (13%; 95% CI 7-18). Hepatotoxicity occurred in 16 patients (10%; 95% CI 6-16) after a median of 85 days. In five cases, treatment was withdrawn due to hepatotoxicity. Use of corticosteroids was associated with hepatotoxicity (OR 4.94; 95% CI 1.01-23.98) with antitumour necrosis factor concomitant therapy showing a protective role (OR 0.3; 95% CI 0.1-3.1). gamma-Glutamyl transferase plasma levels at the onset of hepatotoxicity showed the best predictive value for treatment withdrawal (area under the receiver operating characteristic curve 0.95).CONCLUSIONS:
The incidence of hepatotoxicity in inflammatory bowel disease patients receiving thiopurines is relevant, mainly in patients co-treated with corticosteroids. gamma-Glutamyl transferase plasma level is a useful biomarker in therapy withdrawal prediction.
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Bases de datos:
MEDLINE
Asunto principal:
Enfermedades Inflamatorias del Intestino
/
Enfermedad Hepática Inducida por Sustancias y Drogas
/
Inmunosupresores
/
Mercaptopurina
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Aliment Pharmacol Ther
Asunto de la revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2005
Tipo del documento:
Article
País de afiliación:
España