PDF(Pubmed)
Abstract：
UNASSIGNED: The clinical consequences for patients with inflammatory bowel disease (IBD) who stop treatment owing to side effects have not been fully investigated.
UNASSIGNED: This retrospective observational study aimed to compare patients who discontinued thiopurine treatment due to side effects with those who tolerated thiopurine treatment in the use of other IBD drugs, surgery, and fecal calprotectin values in the first 5 years after the start of thiopurine treatment.
UNASSIGNED: The proportion of patients with IBD who initiated thiopurine treatment at our clinic was 44% (32% ulcerative colitis and 64% Crohn\'s disease) and 31% (n = 94) of those patients had to stop thiopurine treatment within 5 years due to side effects. Patients who discontinued thiopurine treatment due to intolerance were significantly older (median age 33 vs. 27 years, p = 0.003), significantly more often used prednisolone (89 vs. 76%, p = 0.009), and used to a lesser extent TNF inhibitors at the start of thiopurine treatment (3% vs. 9%, p = 0.062). Budesonide treatment and non-TNF inhibitor second-line therapy were significantly more commonly used in patients who discontinued thiopurine treatment owing to side effects, but there were no statistically significant differences in the use of other treatments. The proportion of patients with a median FC >200 μg/g was significantly higher during follow-up in patients with UC who discontinued thiopurine treatment owing to side effects.
UNASSIGNED: Patients who discontinued thiopurines owing to side effects were prescribed more budesonide and non-TNF inhibitor second-line therapy, but there were no differences in the use of TNF inhibitors, prednisolone, or surgery.
UNASSIGNED: This retrospective observational study aimed to compare patients who discontinued thiopurine treatment due to side effects with those who tolerated thiopurine treatment in the use of other IBD drugs, surgery, and fecal calprotectin values in the first 5 years after the start of thiopurine treatment.
UNASSIGNED: The proportion of patients with IBD who initiated thiopurine treatment at our clinic was 44% (32% ulcerative colitis and 64% Crohn\'s disease) and 31% (n = 94) of those patients had to stop thiopurine treatment within 5 years due to side effects. Patients who discontinued thiopurine treatment due to intolerance were significantly older (median age 33 vs. 27 years, p = 0.003), significantly more often used prednisolone (89 vs. 76%, p = 0.009), and used to a lesser extent TNF inhibitors at the start of thiopurine treatment (3% vs. 9%, p = 0.062). Budesonide treatment and non-TNF inhibitor second-line therapy were significantly more commonly used in patients who discontinued thiopurine treatment owing to side effects, but there were no statistically significant differences in the use of other treatments. The proportion of patients with a median FC >200 μg/g was significantly higher during follow-up in patients with UC who discontinued thiopurine treatment owing to side effects.
UNASSIGNED: Patients who discontinued thiopurines owing to side effects were prescribed more budesonide and non-TNF inhibitor second-line therapy, but there were no differences in the use of TNF inhibitors, prednisolone, or surgery.
摘要：
由于副作用而停止治疗的炎症性肠病（IBD）患者的临床后果尚未得到充分研究。
这项回顾性观察性研究旨在比较因副作用而停止噻嘌呤治疗的患者与使用其他IBD药物耐受噻嘌呤治疗的患者，手术,和开始硫嘌呤治疗后的前5年的粪便钙卫蛋白值。
■在我们的诊所开始噻嘌呤治疗的IBD患者比例为44％（32％的溃疡性结肠炎和64％的克罗恩病），其中31％（n=94）由于副作用而不得不在5年内停止噻嘌呤治疗。因不耐受而停止硫嘌呤治疗的患者年龄明显较大（中位年龄33岁vs.27年,p=0.003),明显更经常使用泼尼松龙(89vs.76%,p=0.009),并在硫嘌呤治疗开始时在较小程度上使用TNF抑制剂（3％vs.9%,p=0.062)。布地奈德治疗和非TNF抑制剂二线治疗明显更常用于因副作用而停止噻嘌呤治疗的患者。但在使用其他治疗方法方面没有统计学上的显著差异。在UC患者中，由于副作用而停止硫代嘌呤治疗的患者在随访期间，中位FC>200μg/g的患者比例明显更高。
■因副作用而停药硫嘌呤的患者，给予更多的布地奈德和非TNF抑制剂二线治疗，但是在使用TNF抑制剂方面没有差异，泼尼松龙,或手术。
这项回顾性观察性研究旨在比较因副作用而停止噻嘌呤治疗的患者与使用其他IBD药物耐受噻嘌呤治疗的患者，手术,和开始硫嘌呤治疗后的前5年的粪便钙卫蛋白值。
■在我们的诊所开始噻嘌呤治疗的IBD患者比例为44％（32％的溃疡性结肠炎和64％的克罗恩病），其中31％（n=94）由于副作用而不得不在5年内停止噻嘌呤治疗。因不耐受而停止硫嘌呤治疗的患者年龄明显较大（中位年龄33岁vs.27年,p=0.003),明显更经常使用泼尼松龙(89vs.76%,p=0.009),并在硫嘌呤治疗开始时在较小程度上使用TNF抑制剂（3％vs.9%,p=0.062)。布地奈德治疗和非TNF抑制剂二线治疗明显更常用于因副作用而停止噻嘌呤治疗的患者。但在使用其他治疗方法方面没有统计学上的显著差异。在UC患者中，由于副作用而停止硫代嘌呤治疗的患者在随访期间，中位FC>200μg/g的患者比例明显更高。
■因副作用而停药硫嘌呤的患者，给予更多的布地奈德和非TNF抑制剂二线治疗，但是在使用TNF抑制剂方面没有差异，泼尼松龙,或手术。
