Use of 6-Mercaptopurine/Azathioprine as the Immunomodulator of Choice for Moderately Active Crohnʼs Disease

Jacobstein, Douglas; Baldassano, Robert N.

doi:10.1097/00054725-200502000-00016

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…The benefit of this approach is that corticosteroid use will be minimized, and the adverse effects of steroids on growth and bone development can be avoided. Others argue that uniformly giving 6‐MP will unnecessarily subject a considerable number of patients to a potent immunomodulatory drug 40,41. Hopefully, additional studies will identify the subset of patients that will benefit most from early initiation of 6‐MP.…”

Section: Lesson 5: 6‐mp/aza Therapy At the Onset Of Moderate To Severmentioning

confidence: 99%

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Pediatric Inflammatory Bowel Disease: What Children Can Teach Adults

Hait

Bousvaros

Grand

2005

Inflammatory Bowel Diseases

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Section: Lesson 5: 6‐mp/aza Therapy At the Onset Of Moderate To Severmentioning

confidence: 99%

“…Others argue that uniformly giving 6-MP will unnecessarily subject a considerable number of patients to a potent immunomodulatory drug. 40,41 Hopefully, additional studies will identify the subset of patients that will benefit most from early initiation of 6-MP.…”

Section: Lesson 5: 6-mp/aza Therapy At the Onset Of Moderate To Severmentioning

confidence: 99%

Pediatric Inflammatory Bowel Disease: What Children Can Teach Adults

Hait

Bousvaros

Grand

2005

Inflammatory Bowel Diseases

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“…Our patient responded well to a combination of the 5‐ASA anti‐inflammatory agent, sulfasalazine, and the immunomodulator, 6‐MP at higher than average doses of 2.5 mg/kg/day (average dosing schedule 1.5 mg/kg/day). Levels of 6‐MP metabolite were followed closely (21,22). If steroid sparing and full response to therapy had not been attained on these medications, a second immunomodulator, methotrexate, could have been used in place of 6‐MP (23).…”

Section: Discussionmentioning

confidence: 99%

Infantile Crohn Disease Presenting with Diarrhea and Pyoderma Gangrenosum

Dinulos

Len

Rutledge

et al. 2006

Pediatric Dermatology

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Cutaneous erosions and ulcerations in the diaper area are common in infancy and usually result from local irritation. We describe an infant with chronic diarrhea and failure to thrive who developed extensive ulcerations in the inguinal folds and perineum that were initially thought to be exclusively caused by local irritation. A cutaneous examination found signs consistent with those of pyoderma gangrenosum, leading to a diagnosis of infantile Crohn disease. Cutaneous signs can lead to the diagnosis of an underlying systemic disease in infants with chronic diarrhea and rash. Prompt diagnosis is especially important in infantile Crohn disease, since many infants require surgical resection of affected bowel, and 60% die from disease complications. This article reports a rare instance of an infant who developed pyoderma gangrenosum due to Crohn disease and reviews cutaneous signs of systemic disease in infants presenting with chronic diarrhea and rash.

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The safety and efficacy of adalimumab in patients with Crohn's disease: the experience of a single Canadian tertiary care centre

Teriaky

Gregor

Yan

et al. 2013

Scandinavian Journal of Gastroenterology

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BACKGROUND. Adalimumab (ADA), an antitumor necrosis factor (anti-TNF) monoclonal antibody, is effective in treating moderate-to-severely active Crohn's disease (CD). ADA has been associated with a variety of adverse events (AE). The purpose of this study is to determine the safety and efficacy of ADA in CD patients in clinical practice. METHODS. A retrospective analysis was performed on CD patients treated with ADA. Data extracted and analyzed included patient and CD demographics, remission and response rates with ADA, and safety and tolerability of ADA. RESULTS. A total of 149 ADA-treated CD patients were included. The mean duration of therapy with ADA was 20 months with 32% of patients discontinuing treatment. Anti-TNF-naïve and anti-TNF-exposed patients on ADA achieved clinical remission in 45% and 32%, had a clinical response in 23% and 23%, and had no clinical response in 32% and 45%, respectively. Anti-TNF-naïve and anti-TNF-exposed patients maintained remission in 82% and 67%, respectively. Fistulas healed in 19% and improved in 19%. AE occurred in 38% of patients with infection being the most common (20%). Serious infections lead to death in one (<1%). Logistic regression of AE did not identify statistically significant predictors except for colonic disease location (odds ratio [OR] = 0.31, 95% CI = 0.12-0.82, p = 0.018) and the rate of ADA discontinuation (OR = 3.24, 95% CI = 1.58-6.64, p = 0.0013). CONCLUSION. ADA is an effective treatment for CD. AE can occur commonly leading to discontinuation of medication and may be influenced by disease location. Although serious complications are rare, close monitoring of all patients on ADA is needed.

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Use of 6-Mercaptopurine/Azathioprine as the Immunomodulator of Choice for Moderately Active Crohnʼs Disease

Cited by 3 publications

References 24 publications

Pediatric Inflammatory Bowel Disease: What Children Can Teach Adults

Pediatric Inflammatory Bowel Disease: What Children Can Teach Adults

Infantile Crohn Disease Presenting with Diarrhea and Pyoderma Gangrenosum

The safety and efficacy of adalimumab in patients with Crohn's disease: the experience of a single Canadian tertiary care centre

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