Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients
| Autor: | Tarsila Campanha da Rocha Ribeiro, Luiz Cláudio Ribeiro, Julio Maria Fonseca Chebli, Fernando de Azevedo Lucca, Liliana Andrade Chebli, Pedro Duarte Gaburri, Fábio Heleno de Lima Pace, Fernando Mendonça Vidigal, Alexandre Zanini, Karine Andrade Oliveira Zanini, Maria Cristina Vasconcellos Furtado, Leonardo Duque de Miranda Chaves, Gláucio Silva de Souza |
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| Rok vydání: | 2013 |
| Předmět: |
Crohn’s disease
Adult medicine.medical_specialty Azathioprine Kaplan-Meier Estimate Patient Readmission Gastroenterology law.invention surgery Product Investigations chemistry.chemical_compound Crohn Disease Randomized controlled trial Mesalazine inflammatory bowel disease law Internal medicine medicine Clinical endpoint Humans In patient Mesalamine Crohn's disease azathioprine business.industry Incidence Incidence (epidemiology) General Medicine Middle Aged medicine.disease Surgery Re hospitalization chemistry mesalazine business hospitalization medicine.drug |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 |
| DOI: | 10.12659/msm.889196 |
| Popis: | Background Although the cost of Crohn's disease (CD) treatment differs considerably, hospitalization and surgery costs account for most of the total treatment cost. Decreasing hospitalization and surgery rates are pivotal issues in reducing health-care costs. MATERIAL/METHODS We evaluated the effect of azathioprine (AZA) compared with mesalazine on incidence of re-hospitalizations due to all causes and for CD-related surgeries. In this controlled, randomized study, 72 subjects with sub-occlusive ileocecal CD were randomized for AZA (2-3 mg/kg per day) or mesalazine (3.2 g per day) therapy during a 3-year period. The primary end point was the re-hospitalization proportion due to all causes, as well as for surgical procedures during this period evaluated between the groups. Results On an intention-to-treat basis, the proportion of patients re-hospitalized within 36 months due to all causes was lower in patients treated with AZA compared to those on mesalazine (0.39 vs. 0.83, respectively; p=0.035). The AZA group had also significantly lower proportions of re-hospitalization for surgical intervention (0.25 vs. 0.56, respectively; p=0.011). The number of admissions (0.70 vs. 1.41, p=0.001) and the length of re-hospitalization (3.8 vs. 7.7 days; p=0.002) were both lower in AZA patients. Conclusions Patients with sub-occlusive ileocecal CD treated with AZA had lower re-hospitalization rates due to all causes and for surgical management of CD compared to those treated with mesalazine during a 3-year period. The long-term use of AZA in ileocecal CD patients recovering from a sub-occlusion episode can save healthcare costs. |
| Databáze: | OpenAIRE |
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