BACKGROUND AND AIMS: The efficacy of 6-mercaptopurine (6-MP) in the treatment and long-term maintenance of remission of inflammatory bowel disease and prevention of recurrence after resection in Crohn's disease have been established. Concern about 6-MP toxicity remains, especially the development of neoplasm. The aim of this study is to determine the incidence of all short- and long-term toxicity by follow-up of all patients with inflammatory bowel disease treated with 6-MP over a 20-year period. MATERIALS AND METHODS: We reviewed the office and hospital records and also determined the recent status of 410 patients with inflammatory bowel disease treated with 6-MP from 1980 to 1999. All toxicity was recorded. RESULTS: There was a low incidence of early drug-related allergic reactions (3.9%) and pancreatitis (1.2%). Desensitization to either 6-MP or azathioprine is often successful with the same or the other drug. Significant leukopenia (<or=3500) was observed in 11.5%. In some cases, this was caused purposefully. Infectious complications occurred at different times during treatment with 6-MP in 14%, including pneumonia in 3.9% and herpes zoster in 3%. We now establish diabetes as a 6-MP-related complication. No significant difference in the incidence of neoplasm was seen from our earlier study or from patients not treated with 6-MP. We have now seen three lymphomas and two leukemias, again not greater in incidence than the overall inflammatory bowel disease population. CONCLUSIONS: Our data support the long-term safety of 6-MP in the management of patients with inflammatory bowel disease. Earlier development of a neoplasm in a patient predisposed, without a change in incidence, remains possible.
BACKGROUND AND AIMS: The efficacy of 6-mercaptopurine (6-MP) in the treatment and long-term maintenance of remission of inflammatory bowel disease and prevention of recurrence after resection in Crohn's disease have been established. Concern about 6-MPtoxicity remains, especially the development of neoplasm. The aim of this study is to determine the incidence of all short- and long-term toxicity by follow-up of all patients with inflammatory bowel disease treated with 6-MP over a 20-year period. MATERIALS AND METHODS: We reviewed the office and hospital records and also determined the recent status of 410 patients with inflammatory bowel disease treated with 6-MP from 1980 to 1999. All toxicity was recorded. RESULTS: There was a low incidence of early drug-related allergic reactions (3.9%) and pancreatitis (1.2%). Desensitization to either 6-MP or azathioprine is often successful with the same or the other drug. Significant leukopenia (<or=3500) was observed in 11.5%. In some cases, this was caused purposefully. Infectious complications occurred at different times during treatment with 6-MP in 14%, including pneumonia in 3.9% and herpes zoster in 3%. We now establish diabetes as a 6-MP-related complication. No significant difference in the incidence of neoplasm was seen from our earlier study or from patients not treated with 6-MP. We have now seen three lymphomas and two leukemias, again not greater in incidence than the overall inflammatory bowel disease population. CONCLUSIONS: Our data support the long-term safety of 6-MP in the management of patients with inflammatory bowel disease. Earlier development of a neoplasm in a patient predisposed, without a change in incidence, remains possible.
Authors: James D Lewis; Oren Abramson; Monina Pascua; Liyan Liu; Laura M Asakura; Fernando S Velayos; Susan M Hutfless; James E Alison; Lisa J Herrinton Journal: Clin Gastroenterol Hepatol Date: 2009-07-22 Impact factor: 11.382
Authors: María Chaparro; M Ramas; J M Benítez; A López-García; A Juan; J Guardiola; M Mínguez; X Calvet; L Márquez; L I Fernández Salazar; L Bujanda; C García; Y Zabana; R Lorente; J Barrio; E Hinojosa; M Iborra; M Domínguez Cajal; M Van Domselaar; M F García-Sepulcre; F Gomollón; M Piqueras; G Alcaín; V García-Sánchez; J Panés; E Domènech; E García-Esquinas; F Rodríguez-Artalejo; J P Gisbert Journal: Am J Gastroenterol Date: 2017-05-23 Impact factor: 10.864
Authors: A N Ananthakrishnan; A Cagan; T Cai; V S Gainer; S Y Shaw; S Churchill; E W Karlson; S N Murphy; I Kohane; K P Liao Journal: Aliment Pharmacol Ther Date: 2015-04-13 Impact factor: 8.171