Cumulative experience with short- and long-term toxicity to 6-mercaptopurine in the treatment of Crohn's disease and ulcerative colitis
| Autor: | Mark R. Fleisher, Jonathan I Warman, Ram Janardhanam, Burton I. Korelitz |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Population Azathioprine Gastroenterology Inflammatory bowel disease Drug Administration Schedule Crohn Disease Internal medicine medicine Humans education Child Aged Retrospective Studies Aged 80 and over education.field_of_study Crohn's disease Dose-Response Relationship Drug business.industry Mercaptopurine Incidence (epidemiology) Middle Aged medicine.disease Ulcerative colitis Surgery Pancreatitis Colitis Ulcerative Female business Immunosuppressive Agents medicine.drug Follow-Up Studies |
| Zdroj: | Journal of clinical gastroenterology. 37(3) |
| ISSN: | 0192-0790 |
| Popis: | Background and Aims: The efficacy of 6-mercaptopurine (6-MP) in the treatment and long-term maintenance of remission of inflammatory bowel disease and prevention of recurrence after resection in Crohn's disease have been established. Concern about 6-MP toxicity remains, especially the development of neoplasm. The aim of this study is to determine the incidence of all short- and long-term toxicity by follow-up of all patients with inflammatory bowel disease treated with 6-MP over a 20-year period. Materials and Methods: We reviewed the office and hospital records and also determined the recent status of 410 patients with inflammatory bowel disease treated with 6-MP from 1980 to 1999. All toxicity was recorded. Results: There was a low incidence of early drug-related allergic reactions (3.9%) and pancreatitis (1.2%). Desensitization to either 6-MP or azathioprine is often successful with the same or the other drug. Significant leukopenia (≤3,500) was observed in 11.5%. In some cases, this was caused purposefully. Infectious complications occurred at different times during treatment with 6-MP in 14%, including pneumonia in 3.9% and herpes zoster in 3%. We now establish diabetes as a 6-MP-related complication. No significant difference in the incidence of neoplasm was seen from our earlier study or from patients not treated with 6-MP. We have now seen three lymphomas and two leukemias, again not greater in incidence than the overall inflammatory bowel disease population. Conclusions: Our data support the long-term safety of 6-MP in the management of patients with inflammatory bowel disease. Earlier development of a neoplasm in a patient predisposed, without a change in incidence, remains possible. |
| Databáze: | OpenAIRE |
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