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The use of azathioprine in Crohn's disease during pregnancy and in the post-operative setting: a worldwide survey of experts.
MedLine Citation:
PMID:  21251032     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background  Although thiopurines are considered safe in humans, they are still pregnancy FDA category D drugs. Prevention of post-operative recurrence is a challenge in clinical practice in Crohn's disease. The European Crohn's and Colitis Organisation consensus states that thiopurines should be considered in high-risk patients. Aim  To perform a worldwide survey for evaluating the extent to which gastroenterologists who are experts in the field of IBD are utilising thiopurines during pregnancy and in the post-operative setting in Crohn's disease. Methods  This was a Web-based cross-sectional, statement-based survey, which was conducted among experts who have published at least once in the field of thiopurines in IBD. Results  Between 20 December 2009 and 9 April 2010, 175 questionnaires were received. The median number of IBD patients per physician per year was 400 (IQR 25-75th, 188-600) and the total number of IBD patients followed by all responders was 82 379. In a pregnant woman with a history of severe Crohn's disease in clinical remission after 1 year on azathioprine, 89% of experts usually continue azathioprine until delivery and 9% of physicians never administrate azathioprine during pregnancy. After ileocecal resection for Crohn's disease, 39% of physicians initiate azathioprine only in high-risk patients, 28% of practitioners prescribe azathioprine according to endoscopic evaluation, 20% of gastroenterologists systematically initiate azathioprine and 13% have a different attitude. Conclusions  Almost 9 of 10 physicians continue azathioprine throughout pregnancy. About 7 of 10 physicians prescribe azathioprine in the post-operative setting according to the European Crohn's and Colitis Organisation recommendations, whereas one-fifth of practitioners systematically initiate azathioprine after surgery.
Authors:
L Peyrin-Biroulet; A Oussalah; X Roblin; M P Sparrow
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-20
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  -     ISSN:  1365-2036     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Inserm U954, Henri Poincaré University Nancy 1, Vandoeuvre-lès-Nancy, France. Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France. Department of Hepato-Gastroenterology, University Hospital of Saint-Etienne, Saint-Etienne, France. Department of Gastroenterology, The Alfred Hospital, Melbourne, Vic., Australia.
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