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Goals: To report the 10- year experience of a single center in treating pati ents with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6- mercaptopurine (6- MP). Study: The charts of 285 patients with IBD (Cro hn’ s disease 160 and ulcerative colitis 125) receiving 6- MP were reviewed. C linical response, subsequent breakthrough while taking 6- MP, and relapse rates when 6- MP was discontinued and side effects were assessed. Results: Ninety- three percent of the patients were taking 50 to 75 mg/day of 6- MP. Complete re mission was achieved in 62% , partial remission in 14.5% , and failure to achi eve remission in 23.5% of the patients. Of complete responders, 27.5% had br eakthrough while continuing 6- MP. Nine percent of those that achieved a comple te remission experienced a relapse after 6- MP was discontinued. Side effects i ncluded leukopenia (11.2% ), abnormal liver function tests (3.8% ), various in fections, including pneumonia (3.1% ), pancreatitis (2.5% ), nausea (2.1% ), headache (2.8% ), fever (1.4% ), hair loss (1% ), and rash (0.7% ). Two canc ers occurred while taking 6- MP: melanoma on the finger and a fatal colonic lym phoma. Four patients continued 6- MP throughout pregnancies and had normal outc omes. Conclusions: In our experience 6- MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg/kg per day) compared with the recommend ed higher dosage (1- 1.5 mg/kg per day), when leukopenia was more frequent. Ser ious side effects, although rare, need to be monitored.
Goals: To report the 10-year experience of a single center in treating pati ents with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6- mercaptopurine (6- MP). Study: The charts of 285 patients with IBD MP, and relapse rate 6 - MP was discontinued and side effects were assessed. Results: Ninety-three percent of the patients were taking 50 to 75 mg / day of 6-MP. Complete re mission was achieved in 62%, partial remission in 14.5%, and failure to achi eve remission in 23.5% of the patients. Of complete responders, 27.5% Nine percent of those that achieved a complete remission experienced a relapse after 6 MP was discontinued. Side effects i ncluded leukopenia (11.2%), abnormal liver function tests (3.8%), various in fections, including pneumonia (3.1%), pancreatitis ( 2.5%, nausea 2.1%, headache 2.8%, fever 1.4%, hair loss 1%, and rash 0.7%. Two can c e occurred during taking 6 MP: melanoma on the finger and a fatal colonic lym phoma. Four patients continued 6- MP throughout pregnancies and had normal outc omes. Conclusions: In our experience 6- MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg / kg per day) compared with the recommend ed higher dosage (1- 1.5 mg / kg per day), when leukopenia was more frequent.