Adverse Events Associated with Azathioprine Treatment in Korean Pediatric Inflammatory Bowel Disease Patients
전지영, 강빈, 이유민, 최연호, 이수연, 김미진,
소속 상세정보
전지영 ( Chun Ji-Young )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Pediatrics
강빈 ( Kang Ben )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Pediatrics
이유민 ( Lee Yoo-Min )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Pediatrics
최연호 ( Choe Yon-Ho )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Pediatrics
이수연 ( Lee Soo-Youn )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Laboratory Medicine and Genetics
김미진 ( Kim Mi-Jin )
Inje University College of Medicine Ilsanpaik Hospital Department of Pediatrics
KMID : 0816120130160030171
Abstract
Purpose: This study was aimed to evaluate the frequency and course of adverse events associated with azathioprine treatment in Korean pediatric patients with inflammatory bowel disease.
Methods: Total of 174 pediatric patients (age range, 1 to 19 years) with inflammatory bowel disease who received azathioprine in order to maintain remission at Samsung Medical Center (Seoul, Korea) from January 2002 through December 2012 were included in this study. Medical records of these subjects were retrospectively reviewed regard-ing the development of adverse events associated with azathioprine treatment.
Results: Ninety-eight patients (56.3%) of 174 patients experienced 136 episodes of adverse events, requiring dose reduction in 31 patients (17.8%), and discontinuation in 18 patients (10.3%). The mean dose of azathioprine that had been initially administered was 1.32±0.42 mg/kg/day. Among the adverse reactions, bone marrow suppression developed in 47 patients (27.0%), requiring dose reduction in 22 patients (12.6%) and discontinuation in 8 patients (4.6%). Other adverse events that occurred were gastrointestinal disturbance (15.5%), hair loss (12.1%), pancreatitis (7.5%), arthralgia (6.9%), hepatotoxicity (2.9%), skin rash/allergic reactions (2.9%), headache/dizziness (2.3%), sepsis (0.6%), and oral mucositis (0.6%).
Conclusion: Bone marrow suppression, especially leukopenia was most commonly associated with azathioprine treatment in Korean pediatric inflammatory bowel disease patients. Close observation for possible adverse events is required in this population with inflammatory bowel diseases who are under treatment with azathioprine.
키워드
Inflammatory bowel diseases;Crohn disease;Ulcerative colitis;Azathioprine;Adverse reactions;Bone marrow suppression;Leukopenia
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