Prolonged thioguanine therapy is well tolerated and safe in the treatment of ulcerative colitis.

Autor: van Asseldonk DP; Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands. d.vanasseldonk@vumc.nl, Jharap B, Kuik DJ, de Boer NK, Westerveld BD, Russel MG, Kubben FJ, van Bodegraven AA, Mulder CJ
Jazyk: angličtina
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2011 Feb; Vol. 43 (2), pp. 110-5. Date of Electronic Publication: 2010 Aug 24.
DOI: 10.1016/j.dld.2010.07.004
Abstrakt: Background: Thioguanine has been used for the treatment of inflammatory bowel disease, in particular for patients who failed conventional thiopurine therapy. To date, thioguanine has been infrequently studied in ulcerative colitis.
Aim: To evaluate the tolerability, safety and efficacy of thioguanine in the treatment of ulcerative colitis.
Methods: A database analysis was performed on inflammatory bowel disease patients who had failed conventional thiopurine therapy and were treated with thioguanine. Rates and reasons for treatment failure were assessed. Laboratory values, abdominal ultrasonography, liver biopsy and endoscopic remission rates were evaluated.
Results: Forty-six patients were included and median treatment duration was 22 months (range 0.3-72.0). Nine patients failed thioguanine therapy: six due to adverse events, three due to therapy resistance. Concomitant treatment with aminosalicylates protected against thioguanine failure (hazard ratio (HR) 0.11, 95% CI 0.03-0.48). When performed, ultrasonography (n = 21) revealed no suspected therapy-related pathology in all but one patient, in whom hepatomegaly was observed. Liver histology (n = 12) predominantly revealed no abnormalities (n = 4) or non-specific regeneration (n = 4); none showed nodular regenerative hyperplasia. At follow-up, 40% of colonoscopies revealed endoscopic remission as compared with 10% at baseline (P = 0.180).
Conclusions: Long-term use of thioguanine appears to be well tolerated and relatively safe in ulcerative colitis patients who failed conventional thiopurine therapy.
(Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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