PMID- 37892708
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231030
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 12
IP  - 20
DP  - 2023 Oct 17
TI  - Incidence of Myelotoxicity and Other Adverse Effects Related to Thiopurine 
      Starting in Patients with Inflammatory Bowel Disease: Retrospective Observational 
      Study in a Third-Level Hospital.
LID - 10.3390/jcm12206571 [doi]
LID - 6571
AB  - BACKGROUND AND OBJECTIVES: Thiopurines are an effective treatment for the 
      maintenance of remission in inflammatory bowel disease (IBD). They can present 
      adverse effects (AEs), with myelotoxicity being the most relevant. This study 
      aims to determine the incidence of AEs related to the starting of thiopurines in 
      our centre. METHODOLOGY: Retrospective study. The AEs in patients that were 
      started on thiopurines between January 2016 and June 2020 were registered, with a 
      two-year follow-up. The mean and standard deviation were used to describe the 
      quantitative variables, and percentages and confidence intervals were used for 
      the qualitative variables. The statistical significance was set at a p-value < 
      0.05. RESULTS: 98 patients were included, with 64 AEs detected in 48 patients 
      (49%). Most of the AEs appeared in the first 6 months. The most relevant were: 21 
      neutropenia (21.4%), 19 hypertransaminasemia (19.4%), 13 digestive intolerances 
      (13.2%), 6 acute pancreatitis (6.12%), 3 phototoxicity (3%), and 2 unknown origin 
      fevers (2%). In 29 patients (29.4%) the treatment had to be suspended due to AEs. 
      In 11 cases (11.2%), azathioprine (AZA) was switched to 6-mercaptopurine (6 MP) 
      as 5 showed tolerance and 6 patients needed suspension due to AEs. Eight patients 
      required hospital admission, but none of them needed intensive care unit 
      admission. There were no fatal adverse effects. CONCLUSIONS: Thiopurines are a 
      safe drug with few AEs, especially after the first months of treatment. These 
      results suggest that periodic analytic follow-up may not be necessary after the 
      initial period of treatment.
FAU - Grau, Gerard
AU  - Grau G
AUID- ORCID: 0009-0005-2225-2078
AD  - Servicio Aparato Digestivo, Centro Medico Teknon, 08028 Barcelona, Spain.
FAU - Brunet-Mas, Eduard
AU  - Brunet-Mas E
AUID- ORCID: 0000-0001-8661-0608
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Instituto de Salud Carlos III, 08035 Barcelona, Spain.
FAU - Llovet, Laura Patricia
AU  - Llovet LP
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
FAU - Pedregal, Patricia
AU  - Pedregal P
AD  - Servei de Gastroenterologia, Hospital de la Santa Creu i Sant Pau, Universitat 
      Autonoma de Barcelona, 08193 Barcelona, Spain.
FAU - Villoria, Albert
AU  - Villoria A
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Instituto de Salud Carlos III, 08035 Barcelona, Spain.
FAU - Melcarne, Luigi
AU  - Melcarne L
AUID- ORCID: 0000-0002-9718-9692
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
FAU - Puy, Anna
AU  - Puy A
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
FAU - Garcia-Sague, Belen
AU  - Garcia-Sague B
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
FAU - Frisancho, Luis Enrique
AU  - Frisancho LE
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
FAU - Ramirez-Lazaro, Maria Jose
AU  - Ramirez-Lazaro MJ
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Instituto de Salud Carlos III, 08035 Barcelona, Spain.
FAU - Lario, Sergio
AU  - Lario S
AUID- ORCID: 0000-0001-9294-1585
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Instituto de Salud Carlos III, 08035 Barcelona, Spain.
FAU - Calvet, Xavier
AU  - Calvet X
AUID- ORCID: 0000-0002-6278-9663
AD  - Servei d'Aparell Digestiu, Parc Tauli Hospital Universitari, Institut 
      d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Departament de Medicina, 
      Universitat Autonoma de Barcelona, 08207 Sabadell, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Instituto de Salud Carlos III, 08035 Barcelona, Spain.
AD  - Departament de Medicina, Universitat Autonoma de Barcelona, 08193 Barcelona, 
      Spain.
LA  - eng
PT  - Journal Article
DEP - 20231017
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC10607915
OTO - NOTNLM
OT  - adverse effects neutropenia
OT  - azathioprine
OT  - inflammatory bowel disease
OT  - mercaptopurine
OT  - thiopurine methyltrasferase
OT  - thiopurines
COIS- Albert Villoria has served as a speaker and consultant for MSD and Abbvie. Eduard 
      Brunet-Mas has served as a speaker and consultant for Janssen, Takeda, Kern, and 
      Chiesi. Luigi Melcarne has served as a speaker and consultant for MSD, Abbvie, 
      Janssen, Takeda, Pfizer, and Tillots. Xavier Calvet has received grants for 
      research from Abbott, MSD, and Vifor and fees for advisory board services from 
      Abbott, MSD, Takeda, and Vifor. He has also given lectures for Abbott, MSD, 
      Takeda, Shire, and Allergan. Gerard Grau, Laura-Patricia Llovet, Patricia 
      Pedregal, Anna Puy, Belen Garcia, Luis Enrique Frisancho, Sergio Lario, and Maria 
      Jose Ramirez-Lazaro have no conflict of interest to declare.
EDAT- 2023/10/28 11:45
MHDA- 2023/10/28 11:46
PMCR- 2023/10/17
CRDT- 2023/10/28 01:05
PHST- 2023/09/14 00:00 [received]
PHST- 2023/10/09 00:00 [revised]
PHST- 2023/10/15 00:00 [accepted]
PHST- 2023/10/28 11:46 [medline]
PHST- 2023/10/28 11:45 [pubmed]
PHST- 2023/10/28 01:05 [entrez]
PHST- 2023/10/17 00:00 [pmc-release]
AID - jcm12206571 [pii]
AID - jcm-12-06571 [pii]
AID - 10.3390/jcm12206571 [doi]
PST - epublish
SO  - J Clin Med. 2023 Oct 17;12(20):6571. doi: 10.3390/jcm12206571.