دورية أكاديمية
Impact of thiopurine dose in anti-tumor necrosis factor combination therapy on outcomes in inflammatory bowel disease.
| العنوان: | Impact of thiopurine dose in anti-tumor necrosis factor combination therapy on outcomes in inflammatory bowel disease. |
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| المؤلفون: | Nawaz A; Department of Internal Medicine (Ahmad Nawaz, Laura R. Glick, Abdelkader Chaar)., Glick LR; Department of Internal Medicine (Ahmad Nawaz, Laura R. Glick, Abdelkader Chaar)., Chaar A; Department of Internal Medicine (Ahmad Nawaz, Laura R. Glick, Abdelkader Chaar)., Li DK; Section of Digestive Diseases (Darrick K. Li, Jill K.J. Gaidos, Deborah D. Proctor, Badr Al-Bawardy), Yale School of Medicine, New Haven, CT, USA., Gaidos JKJ; Section of Digestive Diseases (Darrick K. Li, Jill K.J. Gaidos, Deborah D. Proctor, Badr Al-Bawardy), Yale School of Medicine, New Haven, CT, USA., Proctor DD; Section of Digestive Diseases (Darrick K. Li, Jill K.J. Gaidos, Deborah D. Proctor, Badr Al-Bawardy), Yale School of Medicine, New Haven, CT, USA., Al-Bawardy B; Section of Digestive Diseases (Darrick K. Li, Jill K.J. Gaidos, Deborah D. Proctor, Badr Al-Bawardy), Yale School of Medicine, New Haven, CT, USA. |
| المصدر: | Annals of gastroenterology [Ann Gastroenterol] 2023 Jan-Feb; Vol. 36 (1), pp. 39-44. Date of Electronic Publication: 2022 Nov 29. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: The Society Country of Publication: Greece NLM ID: 101121847 Publication Model: Print-Electronic Cited Medium: Print ISSN: 1108-7471 (Print) Linking ISSN: 11087471 NLM ISO Abbreviation: Ann Gastroenterol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Athens, Greece : The Society, [2000- |
| مستخلص: | Background: Combination therapy with thiopurines and anti-tumor necrosis factor (TNF) is superior to monotherapy in Crohn's disease (CD) and ulcerative colitis (UC). The optimal dose of thiopurines in combination therapy remains unclear. We investigated the impact of thiopurine dose in combination therapy on outcomes in inflammatory bowel disease (IBD). Methods: This was a single-center, retrospective study of patients with IBD treated with thiopurine and anti-TNF combination therapy between 1/2012 and 11/2020. A therapeutic dose of thiopurines was defined as ≥1 mg/kg for 6-mercaptopurine and ≥2 mg/kg for azathioprine. The primary outcome was anti-drug antibody (ADA) formation in patients on a therapeutic thiopurine dose vs. a lower thiopurine dose group. Secondary outcomes included steroid-free clinical remission, endoscopic healing (absence of ulcers/erosions in CD and Mayo endoscopic score ≤1 for UC), and normal serum C-reactive protein (CRP) in patients who were on combination therapy. Results: A total of 108 patients were included (median age 31.5 years; 58.3% male). A therapeutic dose of thiopurine was used in 19%. In the therapeutic thiopurine dose group, 23.8% developed ADA vs. 29.9% (P=0.58) in the lower dose group. No significant differences were noted between the therapeutic and lower dose thiopurine groups in terms of steroid-free clinical remission (57.1% vs. 60.9%, P=0.75), endoscopic healing (55% vs. 60%, P=0.69), and normal CRP (52.4% vs. 52.9%, P=0.27). Conclusion: In our cohort of patients with IBD on anti-TNF combination therapy, thiopurine dose was not associated with significant differences in anti-TNF immunogenicity and clinical outcomes. Competing Interests: Conflict of Interest: Dr. Badr Al-Bawardy: Speaker Bureau: AbbVie, Takeda. Advisory board: Bristol-Meyers Squibb, Dr. Jill K. J. Gaidos: Speaker Bureau: AbbVie, Advisory Board: Bristol-Myers Squibb All other authors have no disclosures (Copyright: © Hellenic Society of Gastroenterology.) |
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| معلومات مُعتمدة: | UL1 TR001863 United States TR NCATS NIH HHS |
| فهرسة مساهمة: | Keywords: 6-mercaptopurine; Inflammatory bowel disease; azathioprine; combination therapy |
| تواريخ الأحداث: | Date Created: 20230103 Latest Revision: 20231031 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC9756033 |
| DOI: | 10.20524/aog.2022.0766 |
| PMID: | 36593807 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1108-7471 |
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| DOI: | 10.20524/aog.2022.0766 |