| Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease. | |
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MedLine Citation:
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PMID: 22542605 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: 6-Mercaptopurine is often used as maintenance therapy in patients with Crohn's disease. However, toxicities like myelosuppression limit its clinical benefit. AIMS: To evaluate the efficacy of elemental diet versus 6-mercaptopurine as maintenance therapy in Crohn's disease. METHODS: Ninety-five eligible patients with Crohn's disease activity index ≤150 were randomly assigned to: 6-mercaptopurine (0.5-1.5mg/kg/day, n=30); Elental as an elemental diet (≥900 kcal/day, n=32); none (control, n=33). In the three groups, patients were and remained on 5-aminosalicylic acid (2250-3000 mg/day). Patients were observed for 2 years and the rate of relapse (Crohn's disease activity index ≥200) was monitored. RESULTS: At 24 months, the fractions of patients who had maintained remission were 60%, 46.9% and 27.2% for 6-mercaptopurine, Elental and the control groups, respectively. Log-rank test showed better efficacy for 6-mercaptopurine (P=0.0041) and Elental (P=0.0348) versus control. No significant difference was found between 6-mercaptopurine and Elental. Further, in the 6-mercaptopurine group, 2 patients experienced liver injury and one developed alopecia. CONCLUSIONS: This 24 months comparison study showed that Elental as maintenance therapy in Crohn's disease patients was as effective as 6-mercaptopurine. Elental should be useful for long-term maintenance therapy in Crohn's disease. This is the first comparison study evaluating nutritional therapy versus 6-mercaptopurine. |
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Authors:
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Hiroyuki Hanai; Takayuki Iida; Ken Takeuchi; Hajime Arai; Osamu Arai; Jinrou Abe; Tatsuo Tanaka; Yasuhiko Maruyama; Kentarou Ikeya; Ken Sugimoto; Toshio Nakamura; Kouichi Nakamura; Fumitoshi Watanabe |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2012-04-27 |
Journal Detail:
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Title: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver Volume: 44 ISSN: 1878-3562 ISO Abbreviation: Dig Liver Dis Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-07-09 Completed Date: 2013-01-14 Revised Date: 2013-04-10 |
Medline Journal Info:
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Nlm Unique ID: 100958385 Medline TA: Dig Liver Dis Country: Netherlands |
Other Details:
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Languages: eng Pagination: 649-54 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. All rights reserved. |
Affiliation:
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Centre for Gastroenterology and Inflammatory Bowel Disease Research, Hamamatsu South Hospital, Hamamatsu, Japan. hanai@hamamatsu-minami.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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6-Mercaptopurine
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adverse effects,
therapeutic use* Adult Anti-Inflammatory Agents, Non-Steroidal / therapeutic use Crohn Disease / diet therapy*, drug therapy* Food, Formulated* / adverse effects Humans Immunosuppressive Agents / adverse effects, therapeutic use* Kaplan-Meier Estimate Longitudinal Studies Maintenance Chemotherapy Male Mesalamine / therapeutic use Recurrence Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Immunosuppressive Agents; 50-44-2/6-Mercaptopurine; 89-57-6/Mesalamine |
| Comments/Corrections | |
Comment In:
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Dig Liver Dis. 2013 Mar;45(3):264
[PMID:
22981244
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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