TY - JOUR
T1 - The use of thiopurines for the treatment of inflammatory bowel diseases in clinical practice
AU - Saibeni, S.
AU - Virgilio, T.
AU - D'Incà, R.
AU - Spina, L.
AU - Bortoli, A.
AU - Paccagnella, M.
AU - Peli, M.
AU - Sablich, R.
AU - Meucci, G.
AU - Colombo, E.
AU - Benedetti, G.
AU - Girelli, C. M.
AU - Casella, G.
AU - Grasso, G.
AU - de Franchis, R.
AU - Vecchi, M.
PY - 2008/10
Y1 - 2008/10
N2 - Background: Thiopurines are the most commonly used immunomodulatory drugs in inflammatory bowel diseases. Aim: To evaluate the use, the therapeutic and safety profiles of thiopurines in a large sample of IBD patients. Methods: We reviewed 3641 case histories of IBD patients. Thiopurines were prescribed in 582 patients (16.0%); the analysis was performed on the 553 (267 ulcerative colitis, 286 Crohn's disease) with exhaustive clinical data. Results: The main indications for treatment were steroid-dependence (328/553, 59.3%) and steroid-resistance (113/553, 20.7%). Thiopurines were started when CD were younger than UC patients (p <0.001) but earlier from diagnosis in UC than in CD patients (p = 0.003). Efficacy was defined as optimal (258/553, 46.6%), partial (108/553, 19.5%), absent (85/553, 15.4%) and not assessable (102/553, 18.4%). Efficacy was independent of disease type, location/extension or duration and age at starting. Side effects were observed in 151/553 (27.3%) patients, leading to drug discontinuation in 101 (18.3%). 15 out of the 130 (11.5%) patients who took thiopurines for more than 4 years relapsed, more frequently in CD than in UC (OR = 3.67 95% C.I. 0.98-13.69; p = 0.053). Conclusions: Thiopurines confirm their clinical usefulness and acceptable safety profile in managing complicated IBD patients. The majority of patients treated for longer than 4 years maintain response. No clinical and demographic predictive factors for efficacy and side effects were identified.
AB - Background: Thiopurines are the most commonly used immunomodulatory drugs in inflammatory bowel diseases. Aim: To evaluate the use, the therapeutic and safety profiles of thiopurines in a large sample of IBD patients. Methods: We reviewed 3641 case histories of IBD patients. Thiopurines were prescribed in 582 patients (16.0%); the analysis was performed on the 553 (267 ulcerative colitis, 286 Crohn's disease) with exhaustive clinical data. Results: The main indications for treatment were steroid-dependence (328/553, 59.3%) and steroid-resistance (113/553, 20.7%). Thiopurines were started when CD were younger than UC patients (p <0.001) but earlier from diagnosis in UC than in CD patients (p = 0.003). Efficacy was defined as optimal (258/553, 46.6%), partial (108/553, 19.5%), absent (85/553, 15.4%) and not assessable (102/553, 18.4%). Efficacy was independent of disease type, location/extension or duration and age at starting. Side effects were observed in 151/553 (27.3%) patients, leading to drug discontinuation in 101 (18.3%). 15 out of the 130 (11.5%) patients who took thiopurines for more than 4 years relapsed, more frequently in CD than in UC (OR = 3.67 95% C.I. 0.98-13.69; p = 0.053). Conclusions: Thiopurines confirm their clinical usefulness and acceptable safety profile in managing complicated IBD patients. The majority of patients treated for longer than 4 years maintain response. No clinical and demographic predictive factors for efficacy and side effects were identified.
KW - Inflammatory bowel diseases
KW - Therapy
KW - Thiopurines
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U2 - 10.1016/j.dld.2008.03.016
DO - 10.1016/j.dld.2008.03.016
M3 - Article
C2 - 18479986
AN - SCOPUS:49149112175
VL - 40
SP - 814
EP - 820
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 10
ER -