PMID- 24982311
OWN - NLM
STAT- MEDLINE
DCOM- 20141219
LR  - 20181202
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 48
IP  - 10
DP  - 2014 Oct
TI  - Effect of tumor necrosis factor-alpha inhibitors on drug-induced pancreatitis in 
      inflammatory bowel disease.
PG  - 1282-7
LID - 10.1177/1060028014540869 [doi]
AB  - BACKGROUND: Mesalamine and thiopurines (6-mercaptopurine and azathioprine) have 
      been shown to increase the risk of developing acute pancreatitis in inflammatory 
      bowel disease (IBD) patients. Tumor necrosis factor-alpha (TNF-alpha) inhibitors have 
      been shown to protect against pancreatitis in animal models. OBJECTIVE: To 
      determine the risk of pancreatitis when comparing thiopurine monotherapy, 
      mesalamine monotherapy, and thiopurine and mesalamine dual therapy to identical 
      treatments but with the addition of a TNF-alpha inhibitor. METHODS: Using a 
      case-control design, the Food and Drug Administration Adverse Event Reporting 
      System was queried for cases of pancreatitis and control reactions in IBD 
      patients on a thiopurine or mesalamine. The proportional reporting ratio method 
      was used to compare the different therapy regimens with the same regimen combined 
      with a TNF-alpha inhibitor. RESULTS: In all, 549 cases and controls were identified. 
      When comparing thiopurine monotherapy with thiopurines combined with a TNF-alpha 
      inhibitor, the odds of pancreatitis were lower in those on combination therapy 
      (odds ratio [OR] = 0.04; 95% CI = 0.01-0.12). A similar trend was seen when 
      comparing mesalamine monotherapy to mesalamine combined with a TNF-alpha inhibitor 
      (OR = 0.08; 95% CI = 0.04-0.14) and when comparing those on both a thiopurine and 
      mesalamine with those on all 3 therapies (OR = 0.04; 95% CI = 0.01-0.16). 
      CONCLUSIONS: Combination therapy with TNF-alpha inhibitors appears to be associated 
      with a lower risk of pancreatitis in IBD patients on mesalamine, thiopurines, or 
      a combination of both. Physicians should consider using TNF-alpha inhibitors in those 
      with the greatest risk of pancreatitis, although prospective studies are needed.
CI  - (c) The Author(s) 2014.
FAU - Stobaugh, Derrick J
AU  - Stobaugh DJ
AD  - NorthShore University HealthSystem, Evanston, IL, USA djstobaugh@gmail.com.
FAU - Deepak, Parakkal
AU  - Deepak P
AD  - Mayo Clinic, Rochester, MN, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20140630
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 4Q81I59GXC (Mesalamine)
RN  - E7WED276I5 (Mercaptopurine)
RN  - MRK240IY2L (Azathioprine)
SB  - IM
MH  - Adult
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - Azathioprine/*adverse effects
MH  - Case-Control Studies
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Inflammatory Bowel Diseases/*drug therapy
MH  - Male
MH  - Mercaptopurine/*adverse effects
MH  - Mesalamine/*adverse effects
MH  - Middle Aged
MH  - Odds Ratio
MH  - Pancreatitis/*chemically induced
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
MH  - United States
MH  - United States Food and Drug Administration
MH  - Young Adult
OTO - NOTNLM
OT  - 6-mercaptopurine
OT  - drug-related side effects and adverse reactions
OT  - inflammatory bowel diseases
OT  - mesalamine
OT  - pancreatitis
OT  - tumor necrosis factor
EDAT- 2014/07/02 06:00
MHDA- 2014/12/20 06:00
CRDT- 2014/07/02 06:00
PHST- 2014/07/02 06:00 [entrez]
PHST- 2014/07/02 06:00 [pubmed]
PHST- 2014/12/20 06:00 [medline]
AID - 1060028014540869 [pii]
AID - 10.1177/1060028014540869 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2014 Oct;48(10):1282-7. doi: 10.1177/1060028014540869. Epub 
      2014 Jun 30.