Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease

Background and objectives: Thiopurines are an effective treatment for the maintenance of remission in inflammatory bowel disease (IBD). They can present adverse effects (AEs), with myelotoxicity being the most relevant. This study aims to determine the incidence of AEs related to the starting of thi...

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Autores: Grau, Gerard, Brunet, Eduard|||0000-0001-8661-0608, Llovet, Laura Patricia|||0000-0003-3866-1800, Pedregal-Pascual, Patricia|||0000-0002-0321-9927, Villoria, Albert|||0000-0002-1201-0500, Melcarne, Luigi|||0000-0002-9718-9692, Puy, Anna, García Sagué, Belén|||0000-0001-6501-1227, Frisancho, Luis Enrique, Ramírez-Lázaro, María José|||0000-0002-7044-6126, Lario Garcia, Sergio|||0000-0001-9294-1585, Calvet, Xavier|||0000-0002-6278-9663
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:290185
Acceso en línea:https://ddd.uab.cat/record/290185
https://dx.doi.org/urn:doi:10.3390/jcm12206571
Access Level:acceso abierto
Palabra clave:Adverse effects neutropenia
Azathioprine
Inflammatory bowel disease
Mercaptopurine
Thiopurines
Thiopurine methyltrasferase
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spelling Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel DiseaseRetrospective Observational Study in a Third-Level HospitalGrau, GerardBrunet, Eduard|||0000-0001-8661-0608Llovet, Laura Patricia|||0000-0003-3866-1800Pedregal-Pascual, Patricia|||0000-0002-0321-9927Villoria, Albert|||0000-0002-1201-0500Melcarne, Luigi|||0000-0002-9718-9692Puy, AnnaGarcía Sagué, Belén|||0000-0001-6501-1227Frisancho, Luis EnriqueRamírez-Lázaro, María José|||0000-0002-7044-6126Lario Garcia, Sergio|||0000-0001-9294-1585Calvet, Xavier|||0000-0002-6278-9663Adverse effects neutropeniaAzathioprineInflammatory bowel diseaseMercaptopurineThiopurinesThiopurine methyltrasferaseBackground and objectives: Thiopurines are an effective treatment for the maintenance of remission in inflammatory bowel disease (IBD). They can present adverse effects (AEs), with myelotoxicity being the most relevant. This study aims to determine the incidence of AEs related to the starting of thiopurines in our centre. Methodology: Retrospective study. The AEs in patients that were started on thiopurines between January 2016 and June 2020 were registered, with a two-year follow-up. The mean and standard deviation were used to describe the quantitative variables, and percentages and confidence intervals were used for the qualitative variables. The statistical significance was set at a p -value < 0.05. Results: 98 patients were included, with 64 AEs detected in 48 patients (49%). Most of the AEs appeared in the first 6 months. The most relevant were: 21 neutropenia (21.4%), 19 hypertransaminasemia (19.4%), 13 digestive intolerances (13.2%), 6 acute pancreatitis (6.12%), 3 phototoxicity (3%), and 2 unknown origin fevers (2%). In 29 patients (29.4%) the treatment had to be suspended due to AEs. In 11 cases (11.2%), azathioprine (AZA) was switched to 6-mercaptopurine (6 MP) as 5 showed tolerance and 6 patients needed suspension due to AEs. Eight patients required hospital admission, but none of them needed intensive care unit admission. There were no fatal adverse effects. Conclusions: Thiopurines are a safe drug with few AEs, especially after the first months of treatment. These results suggest that periodic analytic follow-up may not be necessary after the initial period of treatment.Universitat Autònoma de Barcelona 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/290185https://dx.doi.org/urn:doi:10.3390/jcm12206571reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2901852026-06-06T12:50:31Z
dc.title.none.fl_str_mv Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
Retrospective Observational Study in a Third-Level Hospital
title Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
spellingShingle Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
Grau, Gerard
Adverse effects neutropenia
Azathioprine
Inflammatory bowel disease
Mercaptopurine
Thiopurines
Thiopurine methyltrasferase
title_short Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
title_full Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
title_fullStr Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
title_full_unstemmed Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
title_sort Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine Starting in Patients with Inflammatory Bowel Disease
dc.creator.none.fl_str_mv Grau, Gerard
Brunet, Eduard|||0000-0001-8661-0608
Llovet, Laura Patricia|||0000-0003-3866-1800
Pedregal-Pascual, Patricia|||0000-0002-0321-9927
Villoria, Albert|||0000-0002-1201-0500
Melcarne, Luigi|||0000-0002-9718-9692
Puy, Anna
García Sagué, Belén|||0000-0001-6501-1227
Frisancho, Luis Enrique
Ramírez-Lázaro, María José|||0000-0002-7044-6126
Lario Garcia, Sergio|||0000-0001-9294-1585
Calvet, Xavier|||0000-0002-6278-9663
author Grau, Gerard
author_facet Grau, Gerard
Brunet, Eduard|||0000-0001-8661-0608
Llovet, Laura Patricia|||0000-0003-3866-1800
Pedregal-Pascual, Patricia|||0000-0002-0321-9927
Villoria, Albert|||0000-0002-1201-0500
Melcarne, Luigi|||0000-0002-9718-9692
Puy, Anna
García Sagué, Belén|||0000-0001-6501-1227
Frisancho, Luis Enrique
Ramírez-Lázaro, María José|||0000-0002-7044-6126
Lario Garcia, Sergio|||0000-0001-9294-1585
Calvet, Xavier|||0000-0002-6278-9663
author_role author
author2 Brunet, Eduard|||0000-0001-8661-0608
Llovet, Laura Patricia|||0000-0003-3866-1800
Pedregal-Pascual, Patricia|||0000-0002-0321-9927
Villoria, Albert|||0000-0002-1201-0500
Melcarne, Luigi|||0000-0002-9718-9692
Puy, Anna
García Sagué, Belén|||0000-0001-6501-1227
Frisancho, Luis Enrique
Ramírez-Lázaro, María José|||0000-0002-7044-6126
Lario Garcia, Sergio|||0000-0001-9294-1585
Calvet, Xavier|||0000-0002-6278-9663
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Adverse effects neutropenia
Azathioprine
Inflammatory bowel disease
Mercaptopurine
Thiopurines
Thiopurine methyltrasferase
topic Adverse effects neutropenia
Azathioprine
Inflammatory bowel disease
Mercaptopurine
Thiopurines
Thiopurine methyltrasferase
description Background and objectives: Thiopurines are an effective treatment for the maintenance of remission in inflammatory bowel disease (IBD). They can present adverse effects (AEs), with myelotoxicity being the most relevant. This study aims to determine the incidence of AEs related to the starting of thiopurines in our centre. Methodology: Retrospective study. The AEs in patients that were started on thiopurines between January 2016 and June 2020 were registered, with a two-year follow-up. The mean and standard deviation were used to describe the quantitative variables, and percentages and confidence intervals were used for the qualitative variables. The statistical significance was set at a p -value < 0.05. Results: 98 patients were included, with 64 AEs detected in 48 patients (49%). Most of the AEs appeared in the first 6 months. The most relevant were: 21 neutropenia (21.4%), 19 hypertransaminasemia (19.4%), 13 digestive intolerances (13.2%), 6 acute pancreatitis (6.12%), 3 phototoxicity (3%), and 2 unknown origin fevers (2%). In 29 patients (29.4%) the treatment had to be suspended due to AEs. In 11 cases (11.2%), azathioprine (AZA) was switched to 6-mercaptopurine (6 MP) as 5 showed tolerance and 6 patients needed suspension due to AEs. Eight patients required hospital admission, but none of them needed intensive care unit admission. There were no fatal adverse effects. Conclusions: Thiopurines are a safe drug with few AEs, especially after the first months of treatment. These results suggest that periodic analytic follow-up may not be necessary after the initial period of treatment.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/290185
https://dx.doi.org/urn:doi:10.3390/jcm12206571
url https://ddd.uab.cat/record/290185
https://dx.doi.org/urn:doi:10.3390/jcm12206571
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
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