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Increased risk of thiopurine‐related adverse events in elderly patients with IBD
Author(s) -
Calafat Margalida,
Mañosa Míriam,
Cañete Fiorella,
Ricart Elena,
Iglesias Eva,
Calvo Marta,
RodríguezMoranta Francisco,
Taxonera Carlos,
Nos Pilar,
Mesonero Francisco,
MartínArranz María-Dolores,
Mínguez Miguel,
Gisbert Javier P.,
GarcíaLópez Santiago,
de Francisco Ruth,
Gomollón Fernando,
Calvet Xavier,
GarciaPlanella Esther,
Rivero Montserrat,
MartínezCadilla Jesús,
Argüelles Federico,
Arias Lara,
Cimavilla Marta,
Zabana Yamile,
Domènech Eugeni
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15458
Subject(s) - thiopurine methyltransferase , medicine , adverse effect , cohort , azathioprine , disease
Summary Background Thiopurines are the most widely used immunosuppressants in IBD although drug‐related adverse events (AE) occur in 20%‐30% of cases. Aim To evaluate the safety of thiopurines in elderly IBD patients Methods Cohort study including all adult patients in the ENEIDA registry who received thiopurines. Patients were grouped in terms of age at the beginning of thiopurine treatment, specifically in those who started thiopurines over 60 years or between 18 and 50 years of age. Thiopurine‐related AEs registered in the ENEIDA database were compared. Results Out of 48 752 patients, 1888 started thiopurines when over 60 years of age and 15 477 under 50 years of age. Median treatment duration was significantly shorter for those who started thiopurines >60 years (13 [IQR 2‐55] vs 32 [IQR 5‐82] months; P < .001). Patients starting >60 years had higher rates of all types of myelotoxicity, digestive intolerance and hepatotoxicity. Thiopurines were discontinued due to AEs (excluding malignancies and infections) in more patients starting >60 years (67.2% vs 63.1%; P < .001). Elderly age and female sex were independent risk factors for most AEs. Conclusion In elderly IBD patients, thiopurines are associated with an increased risk of non‐infectious, non‐neoplastic, AEs.