Mercaptopurine treatment should be considered in azathioprine intolerant patients with inflammatory bowel disease.
(2009) In Alimentary pharmacology & therapeutics 29(6). p.654-661- Abstract
- BACKGROUND: Adverse drug reactions are a significant reason for therapeutic failure during thiopurine treatment of inflammatory bowel disease. Some smaller series in this patient population have shown that a switch to mercaptopurine may be successful in many cases of azathioprine intolerance. AIM: To assess the long-term outcome of mercaptopurine treatment in a large patient population with azathioprine intolerance. METHODS: We identified 135 patients (74 women; median age 40 years) with Crohn's disease (n = 88) or ulcerative colitis (n = 47) and reviewed their medical records. RESULTS: A total of 70 patients (52%) tolerated mercaptopurine and were followed up for 736 (362-1080) days; 65 patients discontinued mercaptopurine due to adverse... (More)
- BACKGROUND: Adverse drug reactions are a significant reason for therapeutic failure during thiopurine treatment of inflammatory bowel disease. Some smaller series in this patient population have shown that a switch to mercaptopurine may be successful in many cases of azathioprine intolerance. AIM: To assess the long-term outcome of mercaptopurine treatment in a large patient population with azathioprine intolerance. METHODS: We identified 135 patients (74 women; median age 40 years) with Crohn's disease (n = 88) or ulcerative colitis (n = 47) and reviewed their medical records. RESULTS: A total of 70 patients (52%) tolerated mercaptopurine and were followed up for 736 (362-1080) days; 65 patients discontinued mercaptopurine due to adverse events after 25 (8-92) days. Mercaptopurine was tolerated in 71% (12/17) with hepatotoxicity and in 68% (13/19) with arthralgia/myalgia during azathioprine treatment. Previous abdominal surgery was more common in mercaptopurine intolerant patients [39/65 (60%) vs. 27/70 (39%); P = 0.02] and thiopurine methyltransferase activity was higher in mercaptopurine tolerant patients than in mercaptopurine intolerant patients [13.2 (11.4-15.3) vs. 11.8 (9.6-14.2) U/mL red blood cells; P = 0.04; n = 81]. CONCLUSIONS: A trial of mercaptopurine should be considered in azathioprine intolerance, as half of the patients tolerate a switch to mercaptopurine. Patients with hepatotoxicity or arthralgia/myalgia during azathioprine treatment might benefit more often than those with other types of adverse events. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1303011
- author
- Hindorf, Ulf LU ; Johansson, M ; Eriksson, A ; Kvifors, E and Almer, S H C
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Alimentary pharmacology & therapeutics
- volume
- 29
- issue
- 6
- pages
- 654 - 661
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000263344600006
- pmid:19183142
- scopus:60349108861
- pmid:19183142
- ISSN
- 1365-2036
- DOI
- 10.1111/j.1365-2036.2008.03925.x
- language
- English
- LU publication?
- yes
- id
- be58a712-9b09-4061-9f25-85becf826345 (old id 1303011)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19183142?dopt=Abstract
- date added to LUP
- 2016-04-04 09:41:40
- date last changed
- 2024-01-27 14:54:53
@article{be58a712-9b09-4061-9f25-85becf826345,
abstract = {{BACKGROUND: Adverse drug reactions are a significant reason for therapeutic failure during thiopurine treatment of inflammatory bowel disease. Some smaller series in this patient population have shown that a switch to mercaptopurine may be successful in many cases of azathioprine intolerance. AIM: To assess the long-term outcome of mercaptopurine treatment in a large patient population with azathioprine intolerance. METHODS: We identified 135 patients (74 women; median age 40 years) with Crohn's disease (n = 88) or ulcerative colitis (n = 47) and reviewed their medical records. RESULTS: A total of 70 patients (52%) tolerated mercaptopurine and were followed up for 736 (362-1080) days; 65 patients discontinued mercaptopurine due to adverse events after 25 (8-92) days. Mercaptopurine was tolerated in 71% (12/17) with hepatotoxicity and in 68% (13/19) with arthralgia/myalgia during azathioprine treatment. Previous abdominal surgery was more common in mercaptopurine intolerant patients [39/65 (60%) vs. 27/70 (39%); P = 0.02] and thiopurine methyltransferase activity was higher in mercaptopurine tolerant patients than in mercaptopurine intolerant patients [13.2 (11.4-15.3) vs. 11.8 (9.6-14.2) U/mL red blood cells; P = 0.04; n = 81]. CONCLUSIONS: A trial of mercaptopurine should be considered in azathioprine intolerance, as half of the patients tolerate a switch to mercaptopurine. Patients with hepatotoxicity or arthralgia/myalgia during azathioprine treatment might benefit more often than those with other types of adverse events.}},
author = {{Hindorf, Ulf and Johansson, M and Eriksson, A and Kvifors, E and Almer, S H C}},
issn = {{1365-2036}},
language = {{eng}},
number = {{6}},
pages = {{654--661}},
publisher = {{Wiley-Blackwell}},
series = {{Alimentary pharmacology & therapeutics}},
title = {{Mercaptopurine treatment should be considered in azathioprine intolerant patients with inflammatory bowel disease.}},
url = {{http://dx.doi.org/10.1111/j.1365-2036.2008.03925.x}},
doi = {{10.1111/j.1365-2036.2008.03925.x}},
volume = {{29}},
year = {{2009}},
}