硫唑嘌呤治疗炎症性肠病的监测与安全性
Monitoring and safety of azathioprine therapy in inflammatory bowel disease.
作者信息
Kim Mi Jin, Choe Yon Ho
机构信息
Department of Pediatrics, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
出版信息
Pediatr Gastroenterol Hepatol Nutr. 2013 Jun;16(2):65-70. doi: 10.5223/pghn.2013.16.2.65. Epub 2013 Jun 30.
Abstract
Azathioprine is the most common drug used to maintain clinical remission in inflammatory bowel disease. This drug is also important as a steroid-sparing agent in steroid-dependent and chronically active inflammatory bowel disease. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine. The dose of azathioprine has to be reduced or the therapy has to be discontinued frequently because of drug-induced toxicity. In this review, we discuss monitoring of thiopurines, adverse events, malignant complications and how to use azathioprine safely and usefully.
摘要
硫唑嘌呤是用于维持炎症性肠病临床缓解的最常用药物。作为一种在依赖类固醇和慢性活动性炎症性肠病中节省类固醇的药物，该药也很重要。然而，关于硫唑嘌呤的最佳治疗方案仍存在许多问题。由于药物诱导的毒性，硫唑嘌呤的剂量必须减少或治疗必须经常中断。在本综述中，我们讨论了硫嘌呤类药物的监测、不良事件、恶性并发症以及如何安全有效地使用硫唑嘌呤。
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本文引用的文献
1
Validation of new allele-specific real-time PCR system for thiopurine methyltransferase genotyping in Korean population.
Biomed Res Int. 2013;2013:305704. doi: 10.1155/2013/305704. Epub 2013 Feb 28.
2
Thiopurine methyltransferase gene polymorphisms and activity in Chinese patients with inflammatory bowel disease treated with azathioprine.
Chin Med J (Engl). 2012 Oct;125(20):3665-70.
3
Lower doses of 6-mercaptopurine/azathioprine bring enough clinical efficacy and therapeutic concentration of erythrocyte 6-mercaptopurine metabolite in Japanese IBD patients.
J Crohns Colitis. 2008 Dec;2(4):315-21. doi: 10.1016/j.crohns.2008.05.002. Epub 2008 Jul 3.
4
The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Current management.
J Crohns Colitis. 2010 Feb;4(1):28-62. doi: 10.1016/j.crohns.2009.12.002. Epub 2010 Jan 15.
5
A systematic review of factors that contribute to hepatosplenic T-cell lymphoma in patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol. 2011 Jan;9(1):36-41.e1. doi: 10.1016/j.cgh.2010.09.016. Epub 2010 Oct 1.
6
Monitoring 6-thioguanine nucleotide concentrations in Japanese children and adolescents with inflammatory bowel disease.
J Gastroenterol Hepatol. 2010 Oct;25(10):1626-30. doi: 10.1111/j.1440-1746.2010.06364.x.
7
Clinical usefulness of therapeutic drug monitoring of thiopurines in patients with inadequately controlled inflammatory bowel disease.
Inflamm Bowel Dis. 2011 Jun;17(6):1301-7. doi: 10.1002/ibd.21458. Epub 2010 Sep 1.
8
Influences of thiopurine methyltransferase genotype and activity on thiopurine-induced leukopenia in Korean patients with inflammatory bowel disease: a retrospective cohort study.
J Clin Gastroenterol. 2010 Nov-Dec;44(10):e242-8. doi: 10.1097/MCG.0b013e3181d6baf5.
9
Pharmacogenetics of thiopurines in inflammatory bowel disease.
Curr Pharm Des. 2010;16(2):145-54. doi: 10.2174/138161210790112773.
10
Risk of cancer in inflammatory bowel disease treated with azathioprine: a UK population-based case-control study.
Am J Gastroenterol. 2010 Jul;105(7):1604-9. doi: 10.1038/ajg.2009.745. Epub 2010 Jan 26.
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