Mucosal healing for predicting clinical outcome in patients with ulcerative colitis using thiopurines in monotherapy
| Autor: | R. Lana, José Miguel Esteban López-Jamar, Carlos Taxonera, Natalia López-Palacios, Juan Luis Mendoza, Manuel Díaz-Rubio |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Azathioprine Inflammatory bowel disease Gastroenterology Cohort Studies Young Adult Predictive Value of Tests Internal medicine Internal Medicine medicine Humans Intestinal Mucosa Wound Healing Crohn's disease Thiopurine methyltransferase biology medicine.diagnostic_test Mercaptopurine business.industry Colonoscopy Middle Aged medicine.disease Ulcerative colitis Surgery Treatment Outcome Erythrocyte sedimentation rate biology.protein Colitis Ulcerative Female business Immunosuppressive Agents Follow-Up Studies medicine.drug Cohort study |
| Zdroj: | European Journal of Internal Medicine. 22:621-625 |
| ISSN: | 0953-6205 |
| Popis: | Background Mucosal healing (MH) has emerged as a desirable treatment goal for patients with ulcerative colitis (UC). Currently little is known about the efficacy of using thiopurine immunosuppressants in monotherapy to achieve and maintain long-term MH in UC. This study analyzes the efficacy and the clinical impact of MH in patients with UC responded to thiopurine immunosuppressants in the long term. Methods An open, observational, cohort study in 20 patients with UC had been in clinical remission in monotherapy with thiopurine immunosuppressants for at least 1 year. MH was assessed by endoscopy. The patients according to the Mayo Endoscopic Score (0 vs 1 and 2), were followed until the end of the study or patient relapse. (according to Truelove and Witts criteria). Results Mean treatment time was 5.4 years. Twelve (60%) patients presented a Mayo Endoscopic Score of 0. A total of 18 patients were followed up for a median of 27.1 months. After endoscopy, 4 patients (22.2%) presented relapse, with a mean time of 27.5 months for a score ≥ 1 (95% CI; 18.2–36.8) versus 54.3 months for a score = 0 (95% CI 47.2–61.3) (p = 0.032). Conclusions This study shows the efficacy of thiopurine immunosuppressants in achieving mucosal healing in patients who respond to thiopurine immunosuppressants in the long term. We also observe the presence of endoscopy activity is not a rare event in this group of patients and is a predictor of early relapse. |
| Databáze: | OpenAIRE |
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