Literature DB >> 12512024

The safety of 6-mercaptopurine for childbearing patients with inflammatory bowel disease: a retrospective cohort study.

Andrew Francella1, Alan Dyan, Carol Bodian, Peter Rubin, Mark Chapman, Daniel H Present.   

Abstract

BACKGROUND & AIMS: 6-mercaptopurine/azathioprine is effective in IBD patients. However, data regarding toxicity associated with pregnancy are lacking, raising both patients' and physicians' concerns and sometimes resulting in elective abortion.
METHODS: To evaluate potential toxicity of 6-mercaptopurine (6-MP), we reviewed the records of 485 patients who had received the drug. We contacted 462, of whom 155 had conceived at least 1 pregnancy after developing IBD. Pregnancies were analyzed as to whether the patient had taken 6-MP before, or at the time of, conception. These were compared with IBD patients who had their pregnancies before taking 6-MP. We collected data on live births, spontaneous abortions, prematurity, abortions secondary to birth defects, major and minor congenital birth defects, infections, and neoplasia. Outcomes were analyzed comparing pregnancies from men and women who had taken or were currently taking 6-MP to controls.
RESULTS: There was no statistical difference in conception failures (defined as a spontaneous abortion), abortion secondary to a birth defect, major congenital malformations, neoplasia, or increased infections among male or female patients taking 6-MP compared with controls (RR = 0.85 [0.47-1.55], P = 0.59).
CONCLUSIONS: 6-MP use before or at conception or during pregnancy appears to be safe. Discontinuation of the drug before and during pregnancy is not indicated.

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Year:  2003        PMID: 12512024     DOI: 10.1053/gast.2003.50014

Source DB:  PubMed          Journal:  Gastroenterology        ISSN: 0016-5085            Impact factor:   22.682


  62 in total

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Review 4.  Fertility and pregnancy in the patient with inflammatory bowel disease.

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Review 5.  A meta-analysis on the influence of inflammatory bowel disease on pregnancy.

Authors:  J Cornish; E Tan; J Teare; T G Teoh; R Rai; S K Clark; P P Tekkis
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6.  European evidence based consensus on the diagnosis and management of Crohn's disease: special situations.

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Journal:  Gut       Date:  2006-03       Impact factor: 23.059

7.  European evidence based consensus on the diagnosis and management of Crohn's disease: current management.

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Journal:  Gut       Date:  2006-03       Impact factor: 23.059

Review 8.  Inflammatory bowel disease and pregnancy: evidence, uncertainty and patient decision-making.

Authors:  Flavio M Habal; Varun Kapila
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9.  Evidence-based clinical practice guidelines for Crohn's disease, integrated with formal consensus of experts in Japan.

Authors:  Fumiaki Ueno; Toshiyuki Matsui; Takayuki Matsumoto; Katsuyoshi Matsuoka; Mamoru Watanabe; Toshifumi Hibi
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10.  The long-term risk of continuous immunosuppression using thioguanides in inflammatory bowel disease.

Authors:  Anthony O'Connor; Asghar Qasim; Colm A O'Moráin
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