Frequency of Bone Marrow Toxicity by Using Pattern of Azathioprine in Inflammatory Bowel Disease Patients |
Kyung Hee Hyun, Suck-Ho Lee, Jae Min Shin, Dong Il Park2, Chang Kyun Lee3, Jeong Eun Shin4, Chang Soo Eun5, Kyu Chan Huh6, Young Hwangbo7 |
1Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital 2Sungkyunkwan University School of Medicine, Kangbook Samsung Hospital 3Kyunghee University College of Medicine 4Dankook University College of Medicine 5Hanyang University College of Medicine, Kuri Hospital 6Konyang University College of Medicine 7Department of Preventive Medicine, Soonchunhyang University College of Medicine
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염증성 장질환 환자에서 Azathioprine 사용방법에 따른 골수억제 부작용의 빈도 |
현경희, 이석호, 신재민, 박동일2, 이창균3, 신정은4, 은창수5, 허규찬6, 황보영7 |
1순천향대학교 의과대학 천안병원 2성균관대학교 의과대학 강북삼성병원 3경희대학교 의과대학 4단국대학교 의과대학 5한양대학교 의과대학 구리병원 6건양대학교 의과대학 내과학교실 7순천향대학교 의과대학 예방의학교실 |
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Abstract |
Background/Aims The most important adverse effect of azathioprine (AZA) is bone marrow toxicity (BMT). Many physicians have preferred a gradual dose increment (GDI) policy for the prevention of BMT. The aim of this study was to evaluate the efficacy of GDI for the prevention of AZA-induced BMT in inflammatory bowel disease (IBD) patients. Methods: The medical records of IBD patients who received AZA in 6 university hospitals were reviewed. The patients were divided into two groups: the GDI group (initial dose <1.5 mg/kg, gradually increased to a therapeutic dose) and the non-GDI group (initial therapeutic dose ≥2 mg/kg). Results: A total of 308 patients were enrolled (male to female ratio, 1:2.3; mean age, 34.91±14.19 years; ulcerative colitis, 43.5%; Crohn's disease, 55.2%; and intermediate colitis, 1.3%). The overall incidence of BMT was 16.2% (50/308). BMT developed most frequently between fourth to eighth week (26%, 13/50). The rate of BMT of the non-GDI group was significantly higher than that of the GDI group (27.5%, 11/40 vs. 14.6%, 39/268, P=0.038). A multivariate analysis showed that the only factor related to BMT was a non-GDI policy (P=0.036; odds ratio, 2.41; 95% confidence interval, 1.06-5.49). Conclusions: A GDI policy could be useful for reducing AZA-induced BMT in Korean IBD patients. (Intest Res 2012;10: 0-250) |
Key Words:
Inflammatory Bowel Diseases, Azathioprine, Bone Marrow Toxicity |
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