PMID- 28674351 OWN - NLM STAT- MEDLINE DCOM- 20180105 LR - 20221207 IS - 1349-7235 (Electronic) IS - 0918-2918 (Print) IS - 0918-2918 (Linking) VI - 56 IP - 13 DP - 2017 TI - Azathioprine Intolerance in Japanese Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis. PG - 1645-1650 LID - 10.2169/internalmedicine.56.8287 [doi] AB - Objective To assess the safety of azathioprine (AZA) in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods We retrospectively enrolled 67 consecutive AAV patients who had initiated AZA treatment from January 2006 to August 2014 at Okayama University Hospital. We evaluated the development of severe adverse events (AEs), AZA discontinuation due to total AEs (severe AEs included) within 1 year, and AZA-associated risk factors. Results The patients' median age was 70 years old. Forty-nine women and 18 men participated at the initiation of the study. Fifty-eight (87%) patients experienced AEs, and 36 experienced severe AEs (21 hepatic and 11 cytopenic severe AEs). Thirty-one (46%) patients discontinued treatment because of AEs. Abnormal hepatic laboratory test results at the treatment initiation were more frequent in patients with hepatic severe AEs and were associated with treatment discontinuation. The leukocyte and neutrophil counts at the treatment initiation were lower in the patients who discontinued treatment because of cytopenic AEs than in those who continued treatment. Only two patients experienced flare-ups during treatment. Conclusion The AE-associated AZA discontinuation rate in Japanese AAV patients was relatively high. AZA use warrants caution in patients with abnormal hepatic laboratory test results or low leukocyte or neutrophil counts. FAU - Morishita, Michiko AU - Morishita M AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Watanabe, Haruki AU - Watanabe H AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Yan, Minglu AU - Yan M AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Zeggar, Sonia AU - Zeggar S AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Hiramatsu, Sumie AU - Hiramatsu S AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Ohashi, Keiji AU - Ohashi K AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Miyawaki, Yoshia AU - Miyawaki Y AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Katsuyama, Eri AU - Katsuyama E AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Katsuyama, Takayuki AU - Katsuyama T AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Takano Narazaki, Mariko AU - Takano Narazaki M AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Toyota Tatebe, Noriko AU - Toyota Tatebe N AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Sunahori Watanabe, Katsue AU - Sunahori Watanabe K AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Kawabata, Tomoko AU - Kawabata T AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Sada, Ken-Ei AU - Sada KE AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. FAU - Wada, Jun AU - Wada J AD - Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. LA - eng PT - Journal Article DEP - 20170701 PL - Japan TA - Intern Med JT - Internal medicine (Tokyo, Japan) JID - 9204241 RN - 4F4X42SYQ6 (Rituximab) RN - EC 1.6.3.- (NADPH Oxidases) RN - MRK240IY2L (Azathioprine) RN - Granulomatous Disease, Chronic, Autosomal Recessive, Cytochrome B-Positive, Type I SB - IM MH - Aged MH - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug therapy MH - Asian People MH - Azathioprine/*adverse effects/therapeutic use MH - Female MH - Granulomatous Disease, Chronic/metabolism MH - Humans MH - Japan MH - Leukocyte Count MH - Male MH - Middle Aged MH - NADPH Oxidases/deficiency/metabolism MH - Retrospective Studies MH - Rituximab/therapeutic use PMC - PMC5519464 OTO - NOTNLM OT - adverse events OT - anti-neutrophil cytoplasmic antibody-associated vasculitis OT - azathioprine EDAT- 2017/07/05 06:00 MHDA- 2018/01/06 06:00 PMCR- 2017/07/01 CRDT- 2017/07/05 06:00 PHST- 2017/07/05 06:00 [entrez] PHST- 2017/07/05 06:00 [pubmed] PHST- 2018/01/06 06:00 [medline] PHST- 2017/07/01 00:00 [pmc-release] AID - 10.2169/internalmedicine.56.8287 [doi] PST - ppublish SO - Intern Med. 2017;56(13):1645-1650. doi: 10.2169/internalmedicine.56.8287. Epub 2017 Jul 1.