6-硫鸟嘌呤治疗溃疡性或不确定性结肠炎:一项前瞻性、公开标识试验

作     者：Teml A. Schwab M. Harrer M. W. Reinisch 赵天智 

作者机构：Universittsklinik für Innere Medizin IV Abteilung für Gastroenterologie und Hepatologie Whringer Gürtel 18-20 AT-1090 Vienna Austria Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第5期

页      面：56-57页

学科分类：1007[医学-药学(可授医学、理学学位)] 100506[医学-中医内科学] 1006[医学-中西医结合] 1005[医学-中医学] 100602[医学-中西医结合临床] 10[医学] 

主　　题：溃疡性结肠炎 6-硫鸟嘌呤 不确定 治疗 门诊患者 试验 标识 6-巯基嘌呤 皮质激素 6-TG 

摘      要：Objective. 6-thioguanine (6-TG) has emerged as a pro-mising therapeutic alternative in patients with Crohn’ s disease intolerant or resistant to azathioprine (AZA) and/or 6-mercaptopurine (6-MP). The aim of the present study was to evaluate the safety and efficacy of 6-TG in patients with ulcerative colitis (UC) or indeterminate colitis (IC) intolerant or resistant to AZA/6-MP. Material and methods. Twenty patients with an acute flare, steroid-dependent or steroid-refractory disease attending our outpatient department were included in the study. Measurement of 6-TG nucleotide levels was done to check compliance. Complete, partial and non-response were defined by means of the clinical activity index and the daily steroid demand. Secondary outcome parameters included changes in cumulative steroid doses, C-reactive protein (CRP) levels, and an endoscopic score. Results. Out of 20 patients 4 were excluded owing to incompliance; 2/16 compliant patients (13% ) had to be prematurely withdrawn because of adverse events, which ceased upon drug discontinuation. By per-protocol analysis, 5/14 patients (36% )were complete, 6/14 (43% ) partial and 3/14 (21% ) non-responders. In addition to the reduction of the cumulative steroid dose over 3 months, CRP decreased in the study population and the endoscopic score decreased in treatment responders. Conclusions. Treatment with 6-TG was effective in patients with UC or IC previously intolerant or resistant to AZA/6-MP. Future work is needed to define a subpopulation of patients at low risk for its potential hepatotoxicity, which we assume will benefit from 6-TG.