Abstract:
BACKGROUND:Microscopic colitis (MC) is a common chronic diarrhoeal disease, and remission can be induced with budesonide. However, diarrhoea relapses frequently when budesonide is tapered and a few patients become budesonide intolerant. AIM:To examine retrospectively the effect of azathioprine (AZA) and mercaptopurine (MP) in patients with chronic, active MC. METHODS/PATIENTS:Data on all MC patients who received AZA or MP in the years 1997-2011 at three centres representing three countries were pooled for analysis. The indications for thiopurine therapy were frequent relapses after short-term treatment (N = 26), budesonide dependency on 6 mg (N = 15) and budesonide intolerance (N = 5). The response to thiopurine treatment was defined as clinical remission, intolerance or nonresponse. RESULTS:Forty-six MC patients (32 CC and 14 LC), 32 female; median age 59 years (range: 36-83) with a median disease duration of 3 years (range: 0.5-18) were included. Thirteen patients (28%) achieved long-term clinical remission on AZA therapy. AZA failed in 31 patients (67%) due to intolerance and in 2 patients (4%) because of nonresponse. Thirteen of 31 AZA-intolerant patients were switched to MP and 6 patients (46%) obtained clinical remission. Thus, the overall response rate to thiopurines was 19/46 (41%). The main side effects were nausea/vomiting and abnormally elevated liver enzymes. CONCLUSIONS:In this retrospective case series, the majority of chronic, active MC patients were intolerant to AZA leading to cessation of treatment. However, further studies are needed to explore the efficacy, acceptance, tolerance and safety of MP in patients with chronic, active MC refractory to budesonide.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Münch A,Fernandez-Banares F,Munck LKdoi
10.1111/apt.12261subject
Has Abstractpub_date
2013-04-01 00:00:00pages
795-8issue
8eissn
0269-2813issn
1365-2036journal_volume
37pub_type
杂志文章,多中心研究abstract:BACKGROUND:The mucosa-associated microbiota appears to be highly relevant to host-microbe interactions in the gastrointestinal (GI) tract. Thus, precise characterisation of the mucosa-associated microbiota may provide important insights for diagnostic and therapeutic development. However, for technical reasons, mucosal...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13622
更新日期:2016-06-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
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更新日期:2007-08-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
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journal_title:Alimentary pharmacology & therapeutics
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pub_type: 杂志文章
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-04-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,随机对照试验
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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更新日期:2009-08-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
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更新日期:1993-06-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-08-01 00:00:00
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更新日期:2019-03-01 00:00:00
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更新日期:2011-10-01 00:00:00