Effectiveness and safety of azathioprine for inflammatory pouch disorders: results from the RESERVO study of GETECCU
Por:
Mesonero, Francisco, Zabana, Yamile, Fernandez-Clotet, Agnes, Leo-Carnerero, Eduardo, Caballol, Berta, Nunez-Ortiz, Andrea, Garcia, Maria Jose, Bertoletti, Federico, Minguez, Alejandro, Suris, Gerard, Casis, Begona, Ferreiro-Iglesias, Rocio, Calafat, Margalida, Jimenez, Itxaso, Miranda-Bautista, Jose, Lamuela, Luis Javier, Fajardo, Ingrid, Torrealba, Leyanira, Najera, Rodrigo, Saiz-Chumillas, Rosa Maria, Gonzalez, Irene, Vicuna, Miren, Garcia-Morales, Natalia, Gutierrez, Ana, Lopez-Garcia, Alicia, Benitez, Jose Manuel, de Celix, Cristina Rubin, Tejido, Coral, Brunet, Eduard, Hernandez-Camba, Alejandro, Suarez, Cristina, Rodriguez-Lago, Iago, Piqueras, Marta, Castano, Andres, Ramos, Laura, Sobrino, Ana, Rodriguez-Grau, Maria Carmen, Elosua, Alfonso, Montoro, Miguel, Baltar, Ruth, Huguet, Jose Maria, Hermida, Benito, Caballero-Mateos, Antonio, Sanchez-Guillen, Luis, Bouhmidi, Abdel, Pajares, Ramon, Baston-Rey, Iria, Lopez-Sanroman, Antonio, Albillos, Agustin, Barreiro-de Acosta, Manuel
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:
Hosp Univ Ramon Y Cajal, Dept Gastroenterol & Hepatol, Inflammatory
Bowel Dis Unit, Cra Colmenar Km 9-1, Madrid 28034, Spain
Hosp Univ Mutua Terrassa, Terrassa, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAPS,
Barcelona, Spain
Hosp Univ Virgen Rocio, Seville, Spain
Hosp Univ Marques De Valdecilla, IDIVAL, Santander, Spain
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Hosp Univ & Politecn La Fe, Valencia, Spain
Hosp Univ Bellvitge, Barcelona, Spain
Hosp Univ 12 Octubre, Madrid, Spain
Hosp Clin Univ Santiago, Santiago De Compostela, Spain
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Hosp Univ Galdakao, Biocruces Bizkaia Hlth Res Inst, Galdakao, Spain
Hosp Univ Gregorio Maranon, Madrid, Spain
Hosp Univ Miguel Servet, Zaragoza, Spain
Hosp Univ Doctor Josep Trueta, Girona, Spain
Hosp Univ Rio Hortega, Valladolid, Spain
Hosp Univ Burgos, Burgos, Spain
Hosp Univ Puerta Hierro, Madrid, Spain
Complejo Hosp Navarra, Pamplona, Spain
Hosp Alvaro Cunqueiro, Vigo, Spain
Hosp Gen Univ Alicante Doctor Balmis Alicante, Inst Invest Sanitaria &
Biomed Alicante ISABIAL, Alicante, Spain
Hosp Del Mar, Barcelona, Spain
Inst Mar Invest Med IMIM, Barcelona, Spain
Hosp Univ Reina Sofia, Cordoba, Spain
Hosp Univ Princesa, Univ Autonoma Madrid UAM, Inst Invest Sanitaria
Princesa IIS Princesa, Madrid, Spain
Complejo Hosp Univ Ourense, Orense, Spain
Hosp Univ Parc Tauli, Sabadell, Spain
Hosp Univ Nuestra Senora Candelaria, Santa Cruz de La Palma, Spain
Hosp Univ La Paz, Inst Invest Sanitaria Hosp Univ La Paz IdiPAZ, Madrid,
Spain
Consorcio Sanitario Terrassa, Terrassa, Spain
Hosp Univ Cent Asturias, Oviedo, Spain
Hosp Univ Canarias, Santa Cruz de La Palma, Spain
Hosp Gen Univ Ciudad Real, Ciudad Real, Spain
Hosp Univ Henares, Coslada, Spain
Hosp Garcia Orcoyen, Estella, Spain
Hosp Gen Univ San Jorge, Huesca, Spain
Hosp Univ Alava, Vitoria, Spain
Hosp Gen Univ Valencia, Valencia, Spain
Hosp Univ Cabuenes, Gijon, Spain
Hosp Santa Ana Motril, Motril, Spain
Hosp Gen Univ Elche, Elche, Spain
Hosp Santa Barbara, Puertollano, Spain
Hosp Univ Infanta Sofia, San Sebastian De Los Reye, Spain
Hosp Univ Ramon & Cajal, Madrid, Spain
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