b61f92fc78f21c3d3f8388ee725254cc pmc_10607915.pdf c5c1a2c532cbcf61c13f14096f93f248d535a066 pmc_10607915.pdf 7d2f445eb92e63249826b880710b707239eb7bb245000120c6a9458559fa0a85 pmc_10607915.pdf Title: 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 Subject: 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. Keywords: inflammatory bowel disease; thiopurines; azathioprine; mercaptopurine; adverse effects neutropenia; thiopurine methyltrasferase Author: Gerard Grau, Eduard Brunet-Mas, Laura Patricia Llovet, Patricia Pedregal, Albert Villoria, Luigi Melcarne, Anna Puy, Belen Garcia-Sague, Luis Enrique Frisancho, María José Ramírez-Lázaro, Sergio Lario and Xavier Calvet Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Oct 17 09:50:02 2023 CEST ModDate: Tue Oct 17 09:53:17 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 9 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 758535 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- IOJCNK+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 MWHIBA+VnURWPalladioL Type 1 Custom yes yes no 15 0 HPGLSM+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 DHGTVU+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 LSDDQQ+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 DVCMRV+CMSY10 Type 1 Builtin yes yes no 74 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 78 0 URYLRZ+URWPalladioL-BoldItal Type 1 Custom yes yes no 85 0 EEMNJI+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 96 0 EEMLOK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 99 0 EEMLOL+PalatinoLinotype CID TrueType Identity-H yes yes yes 102 0 EEMLOM+PalatinoLinotype TrueType WinAnsi yes yes no 108 0 EEMLOO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 111 0 EEMMMK+PalatinoLinotype TrueType MacRoman yes yes no 114 0 EEMLOK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 128 0 EEMLOL+PalatinoLinotype CID TrueType Identity-H yes yes yes 131 0 EEMLOM+PalatinoLinotype TrueType WinAnsi yes yes no 137 0 EEMLOO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 140 0 EEMMMK+PalatinoLinotype TrueType MacRoman yes yes no 143 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-04-11 02:38:38 CEST RepresentationInformation: pmc_10607915.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-03-15 02:37:22 CET Size: 758535 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 259 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design and Data Collection Destination: subsection.2.1 Item: Title: Population Destination: subsection.2.2 Item: Title: Variables Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Ethical Aspects Destination: subsection.2.5 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.5 Info: Title: 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 Author: Gerard Grau, Eduard Brunet-Mas, Laura Patricia Llovet, Patricia Pedregal, Albert Villoria, Luigi Melcarne, Anna Puy, Belen Garcia-Sague, Luis Enrique Frisancho, María José Ramírez-Lázaro, Sergio Lario and Xavier Calvet Subject: 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. 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