Journal ArticleDOI
Favorable effect of 6-mercaptopurine on fistulae of Crohn's disease.
TLDR
The site of intestinal involvement with Crohn's disease did not appear to play a significant role in the frequency or degree of response to 6-MP, but patients without prior resection and fistulae did better than those with fists occurring after surgery.Abstract:
Fistulae are distressing chronic complications of Crohn's disease which have served as one of the most common indications for surgical resection. While steroids and sulfasalazine have not been successful in closing fistulae, in a previous double-blind study 6-mercaptopurine (6-MP) was more effective than placebo in accomplishing this goal (31% vs 6%). Thirty-four patients with Crohn's disease fistulae were treated with 6-MP for a minimum period of 6 months. In 13 patients (39%) the fistulae closed completely, and in another 9 (26%) there was obvious improvement. All types of fistulae responded to 6-MP with the most impressive closures occurring in patients with fistulae of the abdominal wall and enteroenteric fistulae. The mean time to respond was 3.1 months, with 23% of patients taking longer than 4 months to show any response. Response was not related to other drugs (steroids, sulfasalazine) used in conjunction with the 6-MP. The site of intestinal involvement with Crohn's disease did not appear to play a significant role in the frequency or degree of response to 6-MP, but patients without prior resection and fistulae did better than those with fistulae occurring after surgery. The long-term response to fistulae was good if 6-MP was maintained, whereas exacerbation eventually followed discontinuation of 6-MP. 6-Mercaptopurine is an effective and useful drug in the treatment of fistulae, as it is in other manifestations of chronic unrelenting Crohn's disease.read more
Citations
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Journal ArticleDOI
Pharmacogenomics and metabolite measurement for 6-mercaptopurine therapy in inflammatory bowel disease
Marla Dubinsky,Stéphanie Lamothe,Huiying Yang,Stephan R. Targan,Daniel Sinnett,Yves Théorêt,Ernest G. Seidman +6 more
TL;DR: 6-MP metabolite levels and TPMT genotyping may assist clinicians in optimizing therapeutic response to 6-MP and identifying individuals at increased risk for drug-induced toxicity.
Journal ArticleDOI
Expanded allogeneic adipose-derived mesenchymal stem cells (Cx601) for complex perianal fistulas in Crohn's disease: a phase 3 randomised, double-blind controlled trial.
Julián Panés,Damián García-Olmo,Gert Van Assche,Jean-Frederic Colombel,Walter Reinisch,Walter Reinisch,Daniel C. Baumgart,Axel Dignass,Maria Nachury,Marc Ferrante,Lili Kazemi-Shirazi,Jean Charles Grimaud,Fernando de la Portilla,Eran Goldin,Marie Paule Richard,Anne Leselbaum,Silvio Danese +16 more
TL;DR: Cx601 is an effective and safe treatment for complex perianal fistulas in patients with Crohn's disease who did not respond to conventional or biological treatments, or both.
Journal ArticleDOI
6-Mercaptopurine in the management of inflammatory bowel disease: short- and long-term toxicity.
TL;DR: The data, showing a low incidence of toxicity in 396 patients, coupled with the previously demonstrated efficacy of 6-mercaptopurine in the treatment ofinflammatory bowel disease, indicate that the drug is a reasonable alternative in the management of patients with intractable inflammatory bowel disease.
Journal ArticleDOI
AGA technical review on perianal Crohn's disease.
Journal ArticleDOI
Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease.
TL;DR: There was no statistically significant difference in withdrawals due to adverse events or serious adverse events between antimetabolites and placebo, and azathioprine was significantly inferior to infliximab for induction of steroid-free clinical remission.
References
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Journal ArticleDOI
Treatment of Crohn's disease with 6-mercaptopurine. A long-term, randomized, double-blind study.
Daniel H. Present,Burton I. Korelitz,Nathaniel Wisch,Joseph L. Glass,David B. Sachar,Bernard S. Pasternack +5 more
TL;DR: 6-MP is an effective and useful agent in the management of Crohn's disease and was more effective than placebo in closing fistulas and in permitting discontinuation or reduction of steroid dosage.
Journal ArticleDOI
National Cooperative Crohn's Disease Study: Extraintestinal manifestations and perianal complications
TL;DR: There was a significant positive association between perianal disease and the presence of extraintestinal features, and Perianal abscess appeared to respond to sulfasalazine and anal fissure to prednisone or azathioprine.
Journal ArticleDOI
Healing of perineal Crohn's disease with metronidazole.
TL;DR: If further experience corroborates this prompt and striking response in patients with extreme, disabling, and otherwise unmanageable disease, metronidazole will play an important role in the therapy of perineal Crohn's disease.