Simone Saibeni1, Anna Kohn2, Gianmichele Meucci3, Claudio Papi4. 1. Azienda Ospedaliera Guido Salvini, Ospedale di Rho, Rho, Italy. Electronic address: saibo@tiscali.it. 2. Azienda Ospedaliera San Camillo Forlanini, Rome, Italy. 3. Ospedale San Giuseppe, Milan, Italy. 4. Azienda Ospedaliera San Filippo Neri, Rome, Italy.
Abstract
BACKGROUND: The ideal manner of thiopurine use in inflammatory bowel disease has not been defined. We aimed at investigating the attitudes of Italian gastroenterologists on thiopurine use. METHODS: A web-based survey was performed among 295 gastroenterologists. RESULTS: Overall, 70 surveys were completed. At baseline, thiopurine methyltransferase genotype and phenotype were not assessed by 87.1% and 97.1% of respondents, respectively. At treatment onset, 17.1% adopted full weight-calculated dose while 80.0% preferred escalating the dose. During treatment, 87.1% and 64.3% reduced the dose for myelo- and liver toxicity, respectively; 48.6% for increased pancreatic enzymes, 17.1% for fever, and 5.7% for arthralgia. A systematic shift from one thiopurine to the other was reported by 4.3% of respondents in case of failure, and by 5.7% for adverse effects. Forty-four gastroenterologists (62.9%) stopped thiopurine treatment after 5-7 years. CONCLUSIONS: Several discrepancies regarding the use of thiopurines in clinical practice were found, deviating from available guidelines. A more standardised attitude is needed in clinical practice.
BACKGROUND: The ideal manner of thiopurine use in inflammatory bowel disease has not been defined. We aimed at investigating the attitudes of Italian gastroenterologists on thiopurine use. METHODS: A web-based survey was performed among 295 gastroenterologists. RESULTS: Overall, 70 surveys were completed. At baseline, thiopurine methyltransferase genotype and phenotype were not assessed by 87.1% and 97.1% of respondents, respectively. At treatment onset, 17.1% adopted full weight-calculated dose while 80.0% preferred escalating the dose. During treatment, 87.1% and 64.3% reduced the dose for myelo- and liver toxicity, respectively; 48.6% for increased pancreatic enzymes, 17.1% for fever, and 5.7% for arthralgia. A systematic shift from one thiopurine to the other was reported by 4.3% of respondents in case of failure, and by 5.7% for adverse effects. Forty-four gastroenterologists (62.9%) stopped thiopurine treatment after 5-7 years. CONCLUSIONS: Several discrepancies regarding the use of thiopurines in clinical practice were found, deviating from available guidelines. A more standardised attitude is needed in clinical practice.
Authors: Pu Yao; Xue-Mei Qu; Sai Ren; Xiao-Dong Ren; Ning Su; Na Zhao; Liu Wang; Lin Cheng; Bang-Bi Weng; Feng-Jun Sun; Qing Huang Journal: Mol Med Rep Date: 2020-06-26 Impact factor: 2.952