Effectiveness and safety of azathioprine for inflammatory pouch disorders: results from the RESERVO study of GETECCU

Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders.Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders.Design: This was a retrospective and multicentre study.Methods: We incl...

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Detalles Bibliográficos
Autores: Mesonero, F, Zabana, Y, Fernández-Clotet, A, Leo-Carnerero, E, Caballol, B, Núñez-Ortiz, A, García, MJ, Bertoletti, F, Mínguez, A, Suris, G, Casis, B, Ferreiro-Iglesias, R, Calafat, M, Jiménez, I, Miranda-Bautista, J, Lamuela, LJ, Fajardo, I, Torrealba, L, Nájera, R, Saíz-Chumillas, RM, González, I, Vicuña, M, García-Morales, N, Gutiérrez, A, López-García, A, Benítez, JM, de Célix, CR, Tejido, C, Brunet, E, Hernández-Camba, A, Suárez, C, Rodríguez-Lago, I, Piqueras, M, Castaño, A, Ramos, L, Sobrino, A, Rodríguez-Grau, MC, Elosua, A, Montoro, M, Baltar, R, Huguet, JM, Hermida, B, Caballero-Mateos, A, Sánchez-Guillén, L, Bouhmidi, A, Pajares, R, Baston-Rey, I, López-Sanromán, A, Albillos, A, Barreiro-de Acosta, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p17731
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=17731
https://ddd.uab.cat/record/302208
Access Level:acceso abierto
Palabra clave:azathioprine
immunosuppressants
pouchitis
thiopurines
Descripción
Sumario:Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders.Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders.Design: This was a retrospective and multicentre study.Methods: We included patients diagnosed with inflammatory pouch disorders treated with azathioprine in monotherapy. Effectiveness was evaluated at 1 year and in the long term based on normalization of stool frequency, absence of pain, faecal urgency or fistula discharge (clinical remission), or any improvement in these symptoms (clinical response). Endoscopic response was evaluated using the Pouchitis Disease Activity Index (PDAI).Results: In all, 63 patients were included [54% males; median age, 49 (28-77) years]. The therapy was used to treat pouchitis (n = 37) or Crohn's disease of the pouch (n = 26). The rate of clinical response, remission and non-response at 12 months were 52%, 30% and 18%, respectively. After a median follow-up of 23 months (interquartile range 11-55), 19 patients (30%) were in clinical remission, and 45 (66%) stopped therapy. Endoscopic changes were evaluated in 19 cases. PDAI score decreased from 3 (range 2-4) to 1 (range 0-3). In all, 21 patients (33%) presented adverse events and 16 (25%) needed to stop therapy.Conclusion: Azathioprine may be effective in the long term for the treatment of inflammatory pouch disorders and could be included as a therapeutic option.

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