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Current Clinical Pharmacology
ISSN (Print): 1574-8847
ISSN (Online): 2212-3938
DOI: 10.2174/157488412800958730      Price:  $58

An Aggressive Medical Approach for Inflammatory Bowel Disease: Clinical Challenges and Therapeutic Profiles in a Retrospective Hospitalbased Series

Author(s): Giovanni C. Actis, Floriano Rosina, Rinaldo Pellicano and Mario Rizzetto
Pages 209-213 (5)
Background: We studied the toxicity of cyclosporin (CsA), azathioprine, and mesalamine in 94 patients with inflammatory bowel disease (IBD).

Methods: 63 treatments with CsA (2mg/kg intravenously or 5 mg/kg orally); 57 with azathioprine (2 mg/kg); and 44 with mesalamine (3.2-4.8 gr) were included. After induction, oral CsA was continued for 6 months, azathioprine for a median of 14 months (range 1-201 mos), mesalamine until tolerated.

Results: CsA toxicity frequency 25%: withdrawal and colectomy in 3 cases. AZA toxicity rate: 43% with an overall timeto- onset of a median of 6 months (range 1-60 mos); withdrawal and colectomy in 7 cases; 62% of the events were other than leukopenia. Mesalamine toxicity rates: (13.6%) with one colectomy.

Conclusion: Toxicity-related withdrawal of conventional IBD treatments is significant and leads to colectomy in ulcerative colitis. 50% of the thiopurine toxicities outrange the predicting power of the available pharmacogenomic assays; mesalamine often causes allergic lung dysfunction. Efforts are warranted to optimize this conventional treatment of IBD.

Azathioprine, Crohn’s disease, cyclosporin, inflammatory bowel disease, mesalamine, ulcerative colitis, Hypersensitivity, Infection, Neurotox, Gastric intolerance, Neoplasia, Fatality, Hematologic tox
Division of Gastro- Hepatology, Ospedale Gradenigo, Corso Regina Margherita 10, 10153 Torino, Italy.