Alimentary TractSafety of azathioprine and 6-mercaptopurine in pediatric patients with inflammatory bowel disease☆,☆☆
Section snippets
Materials and methods
A computerized database listing patients with UC and CD evaluated by the author in the Pediatric Gastroenterology Clinic of the University of Chicago Children's Hospital was used to identify patients who had received either AZA or 6-MP. One hundred eighteen patients were identified as having been treated with either of the two preparations. Twenty-three patients were excluded from further analysis for the following reasons: single consultation (n = 11), infrequent visits due to noncompliance (n
Results
Fifty-one of 95 of pediatric patients (54%) tolerated AZA or 6-MP without any adverse reaction. An additional 27 of 95 (28%) experienced an adverse reaction that responded to reduction in medication dose (21 of 27) or improved spontaneously without dose reduction (4 of 27) or after surgery (2 of 27; Table 4).
Specific adverse reaction n % Effect of adverse reaction on
Discussion
The results of this analysis show that AZA and 6-MP are well tolerated in most pediatric and adolescent patients with chronic IBD. Eighty-two percent of patients who were started on these medications were able to remain on therapy. Acute toxicity, characterized by fever or pancreatitis, which required discontinuation of these drugs, occurred in 8% of patients. Because the symptoms of pancreatitis included severe pain necessitating hospitalization in 2 of 4 affected patients, only 2 patients
Acknowledgements
The author thanks Marco Guandalini for technical assistance.
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Address requests fo reprints to: Barbara S. Kirschner, M.D., Section of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Chicago Children's Hospital, 5825 South Maryland Avenue, MC-4065, Chicago, Illinois 60637.
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Supported by Glaxo-Wellcome Inc. and the Martin and Mary Boyer Pediatric Inflammatory Bowel Disease Activities Program, University of Chicago.