儿童炎症性肠病中硫鸟嘌呤的安全性：一项多中心病例系列研究。
Safety of Thioguanine in Pediatric Inflammatory Bowel Disease: A Multi-Center Case Series.
机构信息
From the Faculty of Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
the Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
出版信息
J Pediatr Gastroenterol Nutr. 2022 Dec 1;75(6):e111-e115. doi: 10.1097/MPG.0000000000003621. Epub 2022 Sep 20.
OBJECTIVES
Thioguanine (TG) has been shown as a safe alternative in adults with inflammatory bowel disease (IBD) who did not tolerate conventional thiopurines [azathioprine (AZA)/mercaptopurine]. However, data in pediatric IBD are scarce. Therefore, we aimed to assess the safety of TG as maintenance therapy.
METHODS
A retrospective, multicenter cohort study of children with IBD on TG was performed in the Netherlands. TG-related adverse events (AE) were assessed and listed according to the common terminology criteria for AE.
RESULTS
Thirty-six children with IBD (median age 14.5 years) on TG (median dose 15 mg/day) were included in 6 centers. Five AE occurred during follow-up [pancreatitis (grade 3), hepatotoxicity (grade 3) (n = 2), Clostridium difficile infection (grade 2), and abdominal pain (grade 2)]. All patients (n = 8) with a previously AZA-induced pancreatitis did not redevelop pancreatitis on TG.
CONCLUSIONS
In pediatric IBD, TG seems a safe alternative in case of AZA-induced pancreatitis. Further research assessing long-term TG-related safety and efficacy is needed.
目的
已有研究表明，对于不耐受传统硫嘌呤类药物（巯嘌呤[AZA]/ 硫鸟嘌呤）的炎症性肠病（IBD）成人患者，硫鸟嘌呤（TG）是一种安全的替代药物。然而，儿科 IBD 中相关数据较少。因此，我们旨在评估 TG 作为维持治疗的安全性。
方法
在荷兰，对接受 TG 治疗的 IBD 儿童进行了一项回顾性、多中心队列研究。根据常见不良事件术语标准评估并列出了 TG 相关不良事件（AE）。
结果
共有 6 家中心纳入了 36 名接受 TG（中位剂量 15mg/天）治疗的 IBD 儿童（中位年龄 14.5 岁）。5 例患者在随访期间出现 AE [胰腺炎（3 级）、肝毒性（3 级）（n=2）、艰难梭菌感染（2 级）和腹痛（2 级）]。所有（n=8）曾因 AZA 诱导胰腺炎而停药的患者在改用 TG 后未再发生胰腺炎。
结论
在儿科 IBD 中，TG 似乎是 AZA 诱导胰腺炎时的一种安全替代药物。需要进一步研究以评估 TG 的长期安全性和疗效。
Zotero 插件