| 2 |
Article Open-label infliximab therapy in Crohn's disease: a long-term multicenter study of efficacy, safety and predictors of response. 2008
González-Lama Y, López-San Román A, Marín-Jiménez I, Casis B, Vera I, Bermejo F, Pérez-Calle JL, Taxonera C, Martínez-Silva F, Menchén L, Martínez-Montiel P, Calvo M, Carneros JA, López P, Mendoza JL, Milicua JM, Huerta A, Sánchez F, Abreu L, López-Palacios N, Maté J, Gisbert JP, Anonymous00013. · La Princesa University Hospital (Universidad Autónoma) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd II). · Gastroenterol Hepatol. · Pubmed #18783686 No free full text.
Abstract: BACKGROUND: Efficacy of infliximab in Crohn's disease (CD) showed by randomized controlled trials must be confirmed in clinical practice. We aimed to evaluate efficacy and safety of infliximab in CD patients of the Madrid area, looking for clinical predictors of response. METHODS: Multicenter retrospective survey of all CD patients treated with infliximab in 8 University hospitals of the Madrid area (Spain) with a minimum follow up of 14 wks. RESULTS: 169 patients included (48%males, mean age 39 +/- 12 yrs). 64% of them had perianal disease. 82% were under immunosuppressants. 1,355 infliximab infusions administered (mean 8, range 1-30). 90% response rate and 48% remission rate were obtained with induction therapy. 73% followed maintenance treatment, and 78% of them maintained or improved the response after a mean follow up of 28 months (range 3.5-86). 24 patients lost response during the follow up, after a mean of 41 wks (range 6-248). Only the prescription of maintenance therapy was predictive factor for favourable response (p < 0.01). 17 infusion reactions were reported (10% of the patients, 1.2% of the infusions; only one case was severe) and were the cause of treatment withdrawal in 7 patients. Co-treatment with immunosuppressive drugs and maintenance infliximab therapy were protective factors for infusion reactions (p < 0.05). Other adverse events occurred in 26% of the patients, and were cause of treatment withdrawal in 7 patients. CONCLUSIONS: Infliximab is effective and safe for CD management but concomitant immunosuppressive drugs and maintenance treatment should be prescribed to obtain the best outcome. That confirms in a real life clinical setting the favourable results obtained in randomized clinical trials.
|
| 3 |
Article 6-mercaptopurine in patients with inflammatory bowel disease and previous digestive intolerance of azathioprine. 2005
Domènech E, Nos P, Papo M, López-San Román A, Garcia-Planella E, Gassull MA. · Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. · Scand J Gastroenterol. · Pubmed #15841714 No free full text.
Abstract: OBJECTIVE: Azathioprine and 6-mercaptopurine are useful therapies in inflammatory bowel diseases. Despite their efficacy, their use is limited owing to treatment intolerance or toxicity in 10-15% of patients. It has been suggested that both drugs could be interchangeable. MATERIAL AND METHODS: All patients treated with 6-mercaptopurine because of previous digestive intolerance of azathioprine in four Spanish hospitals were reviewed. Tolerance of 6-mercaptopurine therapy was assessed. RESULTS: Fifteen patients (11 Crohn's disease, 4 ulcerative colitis) were included. Immunosuppressant therapy was prescribed for steroid-dependent disease in 13 cases, and for perianal disease in 2. Main symptoms of digestive intolerance were epigastric pain, nausea and vomiting, which developed within the first weeks of treatment. Acute pancreatitis was ruled out in all the cases. Five patients commenced 6-mercaptopurine immediately after azathioprine discontinuation and 7 patients within the first month. Eleven patients (73.3%) tolerated 6-mercaptopurine and reached the therapeutic goals; only two patients had to discontinue 6-mercaptopurine because of adverse effects. CONCLUSIONS: Treatment with 6-mercaptopurine is a safe alternative in patients with inflammatory bowel diseases and previous digestive intolerance of azathioprine.
|