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Azathioprine and mercaptopurine in the management of patients with chronic, active microscopic colitis.
- Source :
-
Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2013 Apr; Vol. 37 (8), pp. 795-8. Date of Electronic Publication: 2013 Feb 24. - Publication Year :
- 2013
-
Abstract
- Background: Microscopic colitis (MC) is a common chronic diarrhoeal disease, and remission can be induced with budesonide. However, diarrhoea relapses frequently when budesonide is tapered and a few patients become budesonide intolerant.<br />Aim: To examine retrospectively the effect of azathioprine (AZA) and mercaptopurine (MP) in patients with chronic, active MC.<br />Methods/patients: Data on all MC patients who received AZA or MP in the years 1997-2011 at three centres representing three countries were pooled for analysis. The indications for thiopurine therapy were frequent relapses after short-term treatment (N = 26), budesonide dependency on 6 mg (N = 15) and budesonide intolerance (N = 5). The response to thiopurine treatment was defined as clinical remission, intolerance or nonresponse.<br />Results: Forty-six MC patients (32 CC and 14 LC), 32 female; median age 59 years (range: 36-83) with a median disease duration of 3 years (range: 0.5-18) were included. Thirteen patients (28%) achieved long-term clinical remission on AZA therapy. AZA failed in 31 patients (67%) due to intolerance and in 2 patients (4%) because of nonresponse. Thirteen of 31 AZA-intolerant patients were switched to MP and 6 patients (46%) obtained clinical remission. Thus, the overall response rate to thiopurines was 19/46 (41%). The main side effects were nausea/vomiting and abnormally elevated liver enzymes.<br />Conclusions: In this retrospective case series, the majority of chronic, active MC patients were intolerant to AZA leading to cessation of treatment. However, further studies are needed to explore the efficacy, acceptance, tolerance and safety of MP in patients with chronic, active MC refractory to budesonide.<br /> (© 2013 Blackwell Publishing Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic adverse effects
Azathioprine adverse effects
Chronic Disease
Female
Humans
Immunosuppressive Agents adverse effects
Male
Mercaptopurine adverse effects
Middle Aged
Retrospective Studies
Treatment Outcome
Antimetabolites, Antineoplastic therapeutic use
Azathioprine therapeutic use
Colitis, Microscopic drug therapy
Immunosuppressive Agents therapeutic use
Mercaptopurine therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2036
- Volume :
- 37
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Alimentary pharmacology & therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 23432370
- Full Text :
- https://doi.org/10.1111/apt.12261