Document Detail


Nutritional therapy versus 6-mercaptopurine as maintenance therapy in patients with Crohn's disease.
MedLine Citation:
PMID:  22542605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2012-04-27
Journal Detail:
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:
Created Date:  2012-07-09     Completed Date:  2013-01-14     Revised Date:  2013-04-10    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  649-54     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. All rights reserved.
Affiliation:
Centre for Gastroenterology and Inflammatory Bowel Disease Research, Hamamatsu South Hospital, Hamamatsu, Japan. hanai@hamamatsu-minami.com
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MeSH Terms
Descriptor/Qualifier:
6-Mercaptopurine / 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:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Immunosuppressive Agents; 50-44-2/6-Mercaptopurine; 89-57-6/Mesalamine
Comments/Corrections
Comment In:
Dig Liver Dis. 2013 Mar;45(3):264   [PMID:  22981244 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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