Meyer Lital, Simian Daniela, Lubascher Jaime, Acuña Raúl, Figueroa Carolina, Silva Guillermo, Brahm Javier, Quera Rodrigo
Rev Med Chil. 2015 Jan;143(1):7-13. doi: 10.4067/S0034-98872015000100001.
The purpose of inflammatory bowel disease (IBD) treatment is to achieve resolution of symptoms and remission of disease with a minimum of adverse events (AE).
To report AE of different prescriptions used for the treatment of IBD.
Analysis of a registry of patients with IBD held at a private clinic from 1976 to 2013. All used medications, the occurrence and severity of AE were recorded.
The records of 346 patients aged 16 to 86 years, 74% with ulcerative colitis, were analyzed. The most commonly type of medications prescribed were 5-aminosalicylates (5-ASAs) in 329 patients (92%), followed by adrenal steroids in 218 (61%). Forty nine AE were recorded in the same number of patents (14%). These were more common in patients with Crohn disease (n = 19, 21%). An univariate analysis, demonstrated that extra-intestinal manifestations, hospitalizations secondary to IBD crisis, requirement of surgery and treatment with steroids, immunosuppressants or biologic agents were significantly associated with the presence of AE. AEs were more common with immunosuppressants, followed by 5-ASAs and steroids. Discontinuation of therapy was required in 79, 100 and 43% of patients taking these medications, respectively. Twenty percent of AEs were severe. Leukopenia and pancytopenia along with alopecia were the most common AEs attributable to azathioprine.
The occurrence of AEs in patients with IBD is uncommon. Even inmunosuppressants or biologic agents have a low rate of AE and most of them mild.
炎症性肠病（IBD）治疗的目的是在将不良事件（AE）降至最低的情况下实现症状缓解和疾病缓解。
报告用于治疗IBD的不同处方的不良事件。
分析1976年至2013年在一家私人诊所保存的IBD患者登记册。记录所有使用的药物、AE的发生情况和严重程度。
分析了346例年龄在16至86岁之间的患者记录，其中74%患有溃疡性结肠炎。最常开具的药物类型是329例患者（92%）使用的5-氨基水杨酸酯（5-ASA），其次是218例（61%）使用的肾上腺皮质激素。在相同数量的患者（14%）中记录到49例AE。这些在克罗恩病患者中更常见（n = 19，21%）。单因素分析表明，肠外表现、IBD危机继发的住院治疗、手术需求以及使用类固醇、免疫抑制剂或生物制剂治疗与AE的存在显著相关。AE在免疫抑制剂使用者中更常见，其次是5-ASA和类固醇使用者。分别有79%、100%和43%服用这些药物的患者需要停药。20%的AE为严重不良事件。白细胞减少症、全血细胞减少症以及脱发是硫唑嘌呤最常见的AE。
IBD患者中AE的发生并不常见。即使是免疫抑制剂或生物制剂，AE发生率也较低，且大多数为轻度。
