کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8725702 | 1589960 | 2018 | 17 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el uso de tiopurinas en la enfermedad inflamatoria intestinal
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کلمات کلیدی
Mercaptopurineazathioprine - آزاتیوپرین Azatioprina - آزاتیوپریناEnfermedad inflamatoria intestinal - بیماری روده التهابیCrohn's disease - بیماری کرونEnfermedad de Crohn - بیماری کرونInflammatory bowel disease - بیماریهای التهابی رودهthiopurine - تیوپورینMetabolites - متابولیت هاUlcerative colitis - کولیت اولسراتیوColitis ulcerosa - کولیت زخم
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
بیماریهای گوارشی
پیش نمایش صفحه اول مقاله
![عکس صفحه اول مقاله: Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el uso de tiopurinas en la enfermedad inflamatoria intestinal Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el uso de tiopurinas en la enfermedad inflamatoria intestinal](/preview/png/8725702.png)
چکیده انگلیسی
Thiopurines (azathioprine and mercaptopurine) are widely used in patients with inflammatory bowel disease. In this paper, we review the main indications for their use, as well as practical aspects on efficacy, safety and method of administration. They are mainly used to maintain remission in steroid-dependent disease or with ciclosporin to control a severe ulcerative colitis flare-up, as well as to prevent postoperative Crohn's disease recurrence, and also in combination therapy with biologics. About 30-40% of patients will not respond to treatment and 10-20% will not tolerate it due to adverse effects. Before they are prescribed, immunisation status against certain infections should be checked. Determination of thiopurine methyltransferase activity (TPMT) is not mandatory but it increases initial safety. The appropriate dose is 2.5Â mg/kg/day for azathioprine and 1.5Â mg/kg/day for mercaptopurine. Some adverse effects are idiosyncratic (digestive intolerance, pancreatitis, fever, arthromyalgia, rash and some forms of hepatotoxicity). Others are dose-dependent (myelotoxicity and other types of hepatotoxicity), and their surveillance should never be interrupted during treatment. If therapy fails or adverse effects develop, management can include switching from one thiopurine to the other, reducing the dose, combining low doses of azathioprine with allopurinol and assessing metabolites, before their use is ruled out. Non-melanoma skin cancer, lymphomas and urinary tract tumours have been linked to thiopurine therapy. Thiopurine use is safe during conception, pregnancy and breastfeeding.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: GastroenterologÃa y HepatologÃa - Volume 41, Issue 3, March 2018, Pages 205-221
Journal: GastroenterologÃa y HepatologÃa - Volume 41, Issue 3, March 2018, Pages 205-221
نویسندگان
Fernando Bermejo, Mariam Aguas, MarÃa Chaparro, Eugeni Domènech, Ana Echarri, Esther GarcÃa-Planella, Iván Guerra, Javier P. Gisbert, Antonio López-Sanromán, en representación de GETECCU en representación de GETECCU,