Effectiveness and safety of azathioprine for inflammatory pouch disorders: results from the RESERVO study of GETECCU
Por:
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 and Barreiro-de Acosta, M
Publicada:
1 ene 2024
Resumen:
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.
Filiaciones:
Mesonero, F:
Hosp Univ Ramon Y Cajal, Dept Gastroenterol & Hepatol, Inflammatory Bowel Dis Unit, Cra Colmenar Km 9-1, Madrid 28034, Spain
Zabana, Y:
Hosp Univ Mutua Terrassa, Terrassa, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Fernández-Clotet, A:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Leo-Carnerero, E:
Hosp Univ Virgen Rocio, Seville, Spain
Caballol, B:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Núñez-Ortiz, A:
Hosp Univ Virgen Rocio, Seville, Spain
García, MJ:
Hosp Univ Marques de Valdecilla, IDIVAL, Santander, Spain
Bertoletti, F:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Mínguez, A:
Hosp Univ & Politecn La Fe, Valencia, Spain
Suris, G:
Hosp Univ Bellvitge, Barcelona, Spain
Casis, B:
Hosp Univ 12 Octubre, Madrid, Spain
Ferreiro-Iglesias, R:
Hosp Clin Univ Santiago, Santiago De Compostela, Spain
:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Jiménez, I:
Hosp Univ Galdakao, Biocruces Bizkaia Hlth Res Inst, Galdakao, Spain
Miranda-Bautista, J:
Hosp Univ Gregorio Maranon, Madrid, Spain
Lamuela, LJ:
Hosp Univ Miguel Servet, Zaragoza, Spain
Fajardo, I:
Hosp Univ Mutua Terrassa, Terrassa, Spain
Torrealba, L:
Hosp Univ Doctor Josep Trueta, Girona, Spain
Nájera, R:
Hosp Univ Rio Hortega, Valladolid, Spain
Saíz-Chumillas, RM:
Hosp Univ Burgos, Burgos, Spain
González, I:
Hosp Univ Puerta Hierro, Madrid, Spain
Vicuña, M:
Complejo Hosp Navarra, Pamplona, Spain
García-Morales, N:
Hosp Alvaro Cunqueiro, Vigo, Spain
Gutiérrez, A:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Gen Univ Alicante Doctor Balmis Alicante, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Alicante, Spain
López-García, A:
Hosp del Mar, Barcelona, Spain
Inst Mar Invest Med IMIM, Barcelona, Spain
Benítez, JM:
Hosp Univ Reina Sofia, Cordoba, Spain
de Célix, CR:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Princesa, Univ Autonoma Madrid UAM, Inst Invest Sanitaria Princesa IIS Princesa, Madrid, Spain
Tejido, C:
Complejo Hosp Univ Ourense, Orense, Spain
Brunet, E:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Parc Tauli, Sabadell, Spain
Hernández-Camba, A:
Hosp Univ Nuestra Senora Candelaria, Santa Cruz de La Palma, Spain
Suárez, C:
Hosp Univ La Paz, Inst Invest Sanitaria Hosp Univ La Paz IdiPAZ, Madrid, Spain
Rodríguez-Lago, I:
Hosp Univ Galdakao, Biocruces Bizkaia Hlth Res Inst, Galdakao, Spain
Piqueras, M:
Consorcio Sanitario Terrassa, Terrassa, Spain
Castaño, A:
Hosp Univ Cent Asturias, Oviedo, Spain
Ramos, L:
Hosp Univ Canarias, Santa Cruz de La Palma, Spain
Sobrino, A:
Hosp Gen Univ Ciudad Real, Ciudad Real, Spain
Rodríguez-Grau, MC:
Hosp Univ Henares, Coslada, Spain
Elosua, A:
Hosp Garcia Orcoyen, Estella, Spain
Montoro, M:
Hosp Gen Univ San Jorge, Huesca, Spain
Baltar, R:
Hosp Univ Alava, Vitoria, Spain
Huguet, JM:
Hosp Gen Univ Valencia, Valencia, Spain
Hermida, B:
Hosp Univ Cabuenes, Gijon, Spain
Caballero-Mateos, A:
Hosp Santa Ana Motril, Motril, Spain
Sánchez-Guillén, L:
Hosp Gen Univ Elche, Elche, Spain
Bouhmidi, A:
Hosp Santa Barbara, Puertollano, Spain
Pajares, R:
Hosp Univ Infanta Sofia, San Sebastian De Los Reye, Spain
Baston-Rey, I:
Hosp Clin Univ Santiago, Santiago De Compostela, Spain
López-Sanromán, A:
Hosp Univ Ramon & Cajal, Madrid, Spain
Albillos, A:
Hosp Univ Ramon & Cajal, Madrid, Spain
Barreiro-de Acosta, M:
Hosp Clin Univ Santiago, Santiago De Compostela, Spain
Green Published, gold
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