How are thiopurines used and monitored by Swedish gastroenterologists when treating patients with inflammatory bowel disease?
(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)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2151766
- author
- Hindorf, Ulf LU and Andersson, Philip
- organization
- publishing date
- 2011
- 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
- 2016-04-04 09:24:12
- date last changed
- 2024-01-12 13:02:07
@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}}, doi = {{10.3109/00365521.2011.603162}}, volume = {{46}}, year = {{2011}}, }