Thiopurine therapy in inflammatory bowel disease in the pandemic era: Safe or unsafe?

Perdalkar, Shailesh; Mohan, Pooja Basthi; Musunuri, Balaji; Rajpurohit, Siddheesh; Shetty, Shiran; Bhat, K. Subrahmanya; Pai, C. Ganesh

doi:10.1016/j.intimp.2022.109597

International Immunopharmacology

2023

DOI: 10.1016/j.intimp.2022.109597

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Thiopurine therapy in inflammatory bowel disease in the pandemic era: Safe or unsafe?

Shailesh Perdalkar

Pooja Basthi Mohan

Balaji Musunuri

et al.

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2024

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Azathioprine Plus Exclusive Enteral Nutrition Versus Azathioprine Monotherapy for the Prevention of Postoperative Recurrence in Patients with Crohn’s Disease: An Open-Label, Single-Centre, Randomized Controlled Trial

Duan,

Lu,

Diao

et al. 2024

Journal of Crohn's and Colitis

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Background Azathioprine (AZA) effectively prevents postoperative endoscopic recurrence (ER) in Crohn’s disease (CD). However, the efficacy of AZA emerge needs 3 months. Exclusive enteral nutrition (EEN) can maintain remission for CD. The trial investigates whether AZA plus postoperative 3-month EEN is superior to AZA alone in preventing ER of CD. Methods Totally, 84 high-risk CD patients undergoing intestinal resection received AZA alone or AZA plus a 3-month EEN (AZA+EEN) postoperatively. The primary endpoint was the rate of ER at month 12. Secondary endpoint included the rate of ER at month 3, clinical recurrence (CR), CD activity index (CDAI) scores, fecal calprotectin (FC) and CRP. Quality of life were assessed using Short Form-36 (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Results The patients in the AZA+EEN group exhibited significantly lower rates of ER compared to the AZA group at both months 12 (33.3% [13/39] vs 63.2% [24/38], P=0.009) and months 3 (8.6% [3/35] vs 28.1% [9/32], P=0.037) post-surgery. The rates of CR between the two groups at month-3 and month-12 were similar. The CDAI scores, FC, albumin level and CRP were all comparable between the 2 groups. The quality of life was significantly higher in the AZA group than that of the AZA+EEN group at month 3 but became comparable from month 5 to 12 postoperatively. Conclusion In high-risk CD patients, combining AZA with postoperative 3-month EEN reduces 1-year ER but may temporarily impact quality of life. Further large-scale, long-term studies are warranted.

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Azathioprine Plus Exclusive Enteral Nutrition Versus Azathioprine Monotherapy for the Prevention of Postoperative Recurrence in Patients with Crohn’s Disease: An Open-Label, Single-Centre, Randomized Controlled Trial

Duan,

Lu,

Diao

et al. 2024

Journal of Crohn's and Colitis

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Thiopurine therapy in inflammatory bowel disease in the pandemic era: Safe or unsafe?

Cited by 1 publication

References 91 publications

Azathioprine Plus Exclusive Enteral Nutrition Versus Azathioprine Monotherapy for the Prevention of Postoperative Recurrence in Patients with Crohn’s Disease: An Open-Label, Single-Centre, Randomized Controlled Trial

Azathioprine Plus Exclusive Enteral Nutrition Versus Azathioprine Monotherapy for the Prevention of Postoperative Recurrence in Patients with Crohn’s Disease: An Open-Label, Single-Centre, Randomized Controlled Trial

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