Frequency of Bone Marrow Toxicity by Using Pattern of Azathioprine in Inflammatory Bowel Disease Patients.
- Author:
Kyung Hee HYUN
1
;
Suck Ho LEE
;
Jae Min SHIN
;
Dong Il PARK
;
Chang Kyun LEE
;
Jeong Eun SHIN
;
Chang Soo EUN
;
Kyu Chan HUH
;
Young HWANGBO
Author Information
- Publication Type:Original Article
- Keywords: Inflammatory Bowel Diseases; Azathioprine; Bone Marrow Toxicity
- MeSH: Azathioprine; Bone Marrow; Colitis; Colitis, Ulcerative; Crohn Disease; Female; Hospitals, University; Humans; Incidence; Inflammatory Bowel Diseases; Medical Records; Multivariate Analysis; Odds Ratio
- From:Intestinal Research 2012;10(3):244-250
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND/AIMS: The most important adverse effect of azathioprine (AZA) is bone marrow toxicity (BMT). Many physicians have preferred a gradual dose increment (GDI) policy for the prevention of BMT. The aim of this study was to evaluate the efficacy of GDI for the prevention of AZA-induced BMT in inflammatory bowel disease (IBD) patients. METHODS: The medical records of IBD patients who received AZA in 6 university hospitals were reviewed. The patients were divided into two groups: the GDI group (initial dose <1.5 mg/kg, gradually increased to a therapeutic dose) and the non-GDI group (initial therapeutic dose > or =2 mg/kg). RESULTS: A total of 308 patients were enrolled (male to female ratio, 1:2.3; mean age, 34.91+/-14.19 years; ulcerative colitis, 43.5%; Crohn's disease, 55.2%; and intermediate colitis, 1.3%). The overall incidence of BMT was 16.2% (50/308). BMT developed most frequently between fourth to eighth week (26%, 13/50). The rate of BMT of the non-GDI group was significantly higher than that of the GDI group (27.5%, 11/40 vs. 14.6%, 39/268, P=0.038). A multivariate analysis showed that the only factor related to BMT was a non-GDI policy (P=0.036; odds ratio, 2.41; 95% confidence interval, 1.06-5.49). CONCLUSIONS: A GDI policy could be useful for reducing AZA-induced BMT in Korean IBD patients.
