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Multicenter Study
. 2019 Oct;50(7):780-788.
doi: 10.1111/apt.15458. Epub 2019 Aug 19.

Increased risk of thiopurine-related adverse events in elderly patients with IBD

Margalida Calafat  1   2 , Míriam Mañosa  3   4 , Fiorella Cañete  3   4 , Elena Ricart  2   4 , Eva Iglesias  5 , Marta Calvo  6 , Francisco Rodríguez-Moranta  7 , Carlos Taxonera  4 , Pilar Nos  4   8 , Francisco Mesonero  4 , María-Dolores Martín-Arranz  4 , Miguel Mínguez  8 , Javier P Gisbert  4 , Santiago García-López  9 , Ruth de Francisco  10 , Fernando Gomollón  4   9 , Xavier Calvet  4   11 , Esther Garcia-Planella  2 , Montserrat Rivero  12 , Jesús Martínez-Cadilla  13 , Federico Argüelles  14 , Lara Arias  15 , Marta Cimavilla  16 , Yamile Zabana  4   17 , Eugeni Domènech  3   4 ; ENEIDA registry of GETECCU
Collaborators, Affiliations
Multicenter Study

Increased risk of thiopurine-related adverse events in elderly patients with IBD

Margalida Calafat et al. Aliment Pharmacol Ther. 2019 Oct.

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Aliment Pharmacol Ther. 2020 Mar;51(6):674. doi: 10.1111/apt.15672. Aliment Pharmacol Ther. 2020. PMID: 32100352 No abstract available.

Abstract

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.

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References

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