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How are thiopurines used and monitored by Swedish gastroenterologists when treating patients with inflammatory bowel disease?

Hindorf, Ulf LU and Andersson, Philip (2011) In Scandinavian Journal of Gastroenterology 46. p.1215-1221
Abstract
Objective. To perform a survey of thiopurine treatment in inflammatory bowel disease (IBD) among Swedish gastroenterologists. Material and methods. A web-based questionnaire consisting of 25 multiple-choice questions was sent to 322 gastroenterologists in adult practice. Results. A total of 132 questionnaires were received giving a response rate of 41%. Thiopurines were used by all 122 gastroenterologists in IBD practice and azathioprine was the first-choice thiopurine among 118 (97%) of them. Almost all gastroenterologists (97%) used weight-based dosing that was gradually escalated. The vast majority (89%) considered that efficacy should be evaluated within 6 months of therapy, while opinions regarding the optimal duration of therapy... (More)
Objective. To perform a survey of thiopurine treatment in inflammatory bowel disease (IBD) among Swedish gastroenterologists. Material and methods. A web-based questionnaire consisting of 25 multiple-choice questions was sent to 322 gastroenterologists in adult practice. Results. A total of 132 questionnaires were received giving a response rate of 41%. Thiopurines were used by all 122 gastroenterologists in IBD practice and azathioprine was the first-choice thiopurine among 118 (97%) of them. Almost all gastroenterologists (97%) used weight-based dosing that was gradually escalated. The vast majority (89%) considered that efficacy should be evaluated within 6 months of therapy, while opinions regarding the optimal duration of therapy varied considerably. It was seen that 74% switched thiopurine in case of intolerance to the first-line substance. Thiopurine S-methyltransferase (TPMT) determinations were performed by 74% of the gastroenterologists and 67% used metabolite measurements. TPMT analyzers were more likely to measure metabolites (74 vs. 43%, p = 0.002). A quarter of the respondents were familiar with unconventional immunomodulation (co-administration of allopurinol, 6-thioguanine, mycophenolate mofetil or tacrolimus) and these respondents were also more likely to measure metabolites (79 vs. 52%; p = 0.002). Conclusions. Thiopurines are well established in the treatment of IBD among Swedish gastroenterologists. New and evolving knowledge about thiopurine therapy in IBD has been adapted to a large extent. Whether this change in clinical practice will have an impact on treatment outcomes has yet to be proven. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Gastroenterology
volume
46
pages
1215 - 1221
publisher
Taylor & Francis
external identifiers
  • wos:000294911600008
  • pmid:21793634
  • scopus:80052891355
ISSN
1502-7708
DOI
10.3109/00365521.2011.603162
language
English
LU publication?
yes
id
cf8158eb-14e3-485b-a549-d3364adf6a64 (old id 2151766)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21793634?dopt=Abstract
date added to LUP
2011-09-04 20:50:03
date last changed
2017-01-01 07:48:12
@article{cf8158eb-14e3-485b-a549-d3364adf6a64,
  abstract     = {Objective. To perform a survey of thiopurine treatment in inflammatory bowel disease (IBD) among Swedish gastroenterologists. Material and methods. A web-based questionnaire consisting of 25 multiple-choice questions was sent to 322 gastroenterologists in adult practice. Results. A total of 132 questionnaires were received giving a response rate of 41%. Thiopurines were used by all 122 gastroenterologists in IBD practice and azathioprine was the first-choice thiopurine among 118 (97%) of them. Almost all gastroenterologists (97%) used weight-based dosing that was gradually escalated. The vast majority (89%) considered that efficacy should be evaluated within 6 months of therapy, while opinions regarding the optimal duration of therapy varied considerably. It was seen that 74% switched thiopurine in case of intolerance to the first-line substance. Thiopurine S-methyltransferase (TPMT) determinations were performed by 74% of the gastroenterologists and 67% used metabolite measurements. TPMT analyzers were more likely to measure metabolites (74 vs. 43%, p = 0.002). A quarter of the respondents were familiar with unconventional immunomodulation (co-administration of allopurinol, 6-thioguanine, mycophenolate mofetil or tacrolimus) and these respondents were also more likely to measure metabolites (79 vs. 52%; p = 0.002). Conclusions. Thiopurines are well established in the treatment of IBD among Swedish gastroenterologists. New and evolving knowledge about thiopurine therapy in IBD has been adapted to a large extent. Whether this change in clinical practice will have an impact on treatment outcomes has yet to be proven.},
  author       = {Hindorf, Ulf and Andersson, Philip},
  issn         = {1502-7708},
  language     = {eng},
  pages        = {1215--1221},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {How are thiopurines used and monitored by Swedish gastroenterologists when treating patients with inflammatory bowel disease?},
  url          = {http://dx.doi.org/10.3109/00365521.2011.603162},
  volume       = {46},
  year         = {2011},
}