No increased risk of nephrotoxicity associated with 5-aminosalicylic acid in IBD: a population-based cohort and nested case-control study.
Aliment Pharmacol Ther
; 50(4): 416-424, 2019 08.
Article
en En
| MEDLINE
| ID: mdl-31298421
ABSTRACT
BACKGROUND:
There is conflicting evidence about nephrotoxicity risk associated with 5-aminosalicylates for treatment of IBD.AIMS:
To determine population-based temporal trends for 5-aminosalicylates and estimated risk of nephrotoxicity associated with 5-aminosalicylate use for ulcerative colitis (UC) and Crohn's disease (CD).METHODS:
Retrospective cohort and nested case-control study, using the Health Improvement Network primary care database linked to hospital discharge coding for patients in England, 1996-2017. Nephrotoxicity risk analysis was a first recorded renal impairment diagnosis adjusted for key variables and was assessed between 2008 and 2017.RESULTS:
A total of 35 601 patients with prevalent UC or CD were included. The proportion of patients prescribed 5-aminosalicylates fell from 83% in 1996-1999 to 71% in 2012-2015 for UC patients and 64% to 45% for CD patients. Thirty per cent of patients had prolonged 5-aminosalicylate use. Between 2008 and 2017, the incident rate of nephrotoxicity was similar and stable for UC (12.6/1000 person-years) and CD (10.9/1000 person-years) patients. Multivariate analysis showed no evidence for association between current prescription of 5-aminosalicylate and nephrotoxicity in UC or CD patients, comparing ≤ 30 days prescription prior to index vs 31-≤180 days. However, active disease, disease duration, concomitant cardiovascular disease or diabetes and nephrotoxic drug use were independently associated with development of nephrotoxicity in UC and CD.CONCLUSIONS:
Despite the paucity of evidence for their benefit, 5-aminosalicylates were prescribed to approximately half of CD patients (30% prolonged therapy). Nephrotoxicity was rare in this patient cohort, and was not associated with 5-aminosalicylate use, but rather with disease status, comorbidity and use of nephrotoxic drugs.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades Inflamatorias del Intestino
/
Mesalamina
/
Enfermedades Renales
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Aliment Pharmacol Ther
Asunto de la revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2019
Tipo del documento:
Article
País de afiliación:
Canadá