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| 1 | Clinical predictors of thiopurine-related adverse events in Crohn's disease显示文摘AIM: To determine the incidence and predictors of thiopurine-related adverse events. METHODS: Subjects with Crohn's disease who were followed in the Alberta Inflammatory Bowel Disease Consortium patient database registry were identified. Retrospective chart review was conducted between August 5th, 2010 and June 1st, 2012. We collected data on: age at diagnosis; sex; disease location and behaviour at time of prescribing thiopurine; perianal fistulising disease at or prior to thiopurine prescription; smoking status at time of thiopurine prescription, use of corticosteroid within 6 mo of diagnosis; dosage, age at onset, and cessation of 5-aminosalicyclic acid(5-ASA); anti-tumour necrosis factor medication exposure and intestinal resection before thiopurine prescription. The primary outcome of interest was the first adverse event that led to discontinuation of the first thiopurine medication used. Logistic regression models were used to associate clinical characteristics with outcomes after adjusting for potential confounders. Risk estimates were presented as odds ratios(OR) with 95% CI. Effect modification by age and sex were explored.RESULTS: Our cohort had a median follow-up duration of 5.8 years [interquartile range(IQR 25th-75th) 2.7-9.1]. Thiopurine therapy was discontinued in 31.3% of patients because of: hypersensitivity reactions(7.1%), acute pancreatitis(6.2%), gastrointestinal intolerance(5.4%), leucopenia(3.7%), hepatotoxicity(3.4%), infection(1.1%) and other reasons(4.3%). A higher incidence of thiopurine withdrawal was observed in patients over the age of 40(39.4%, P = 0.007). A sexby-age interaction(P = 0.04) was observed. Females older than 40 years of age had an increased risk of thiopurine discontinuation due to an adverse event(age above 40 vs age below 40, adjusted OR = 2.8; 95%CI: 1.4-5.6). In contrast, age did not influence thiopurine withdrawal in males(age above 40 vs below 40, adjusted OR = 0.9; 95%CI: 0.4-2.1). Other clinical variables(disease location and phenotype, perianal disease, smoking history, history of intestinal resection and prior 5-ASA or corticosteroid use) were not associated with an increased risk an adverse event leading to therapy cessation. CONCLUSION: Thiopurine withdrawal due to adverse events is commoner in women over the age of 40 at prescription. These findings need to be replicated in other cohorts. | Gordon W Moran Marie-France Dubeau Gilaad G Kaplan Hong Yang Bertus Eksteen Subrata Ghosh Remo Panaccione | 2015 | World Journal of Gastroenterology2015，21，25： | 2 |
| 2 | Antimicrobial and antioxidant activities of unripe papaya 显示文摘 | OSATO J A SANTIAG L A REMO G M CUADRA M S MORI A | 1993 | Life Science1993，53，： | 1 |
| 3 | Solution structure of ZASP PDZ domain : implications for sarcomere ultrastructure and enigma family redundancy 显示文摘 | Yunghan A Andrew A Remo G | 2004 | Structure2004，12，： | 1 |
| 4 | Solution Structure of ZASP PDZ Domain : Implications for Sareomere Ultrastructureand Enigma Family Redundancy 显示文摘 | Yung HA Andrew A Remo G | 2004 | Elsevier Science Ltd2004，11，4： | 1 |
| 5 | Immune escape mechanisms in colorectal cancer pathogenesis and liver metastasis显示文摘 | PANCIONE M GIORDANO G REMO A | 2014 | J Immunol Res2014，2014，68： | 1 |
| 6 | Presence of the tet(O) gene in erythromycin-and tetracycline-resistant strains of Streptococcus pyogenes and linkage with either the mef(A) or the erm(A) gene显示文摘 | Eleonora G Andrea B Remo L | 2003 | Antimicrob Agents Chemother2003，47，9： | 1 |
| 7 | Immune escape mechanisms in colorectal cancer pathogenesis and liver metastasis 显示文摘 | Pancione M Giordano G Remo A | 2014 | J Immunol Res2014，2014，68： | 1 |
| 8 | Antimicrobial and antioxidant activities of unripe papaya显示文摘 | Santiago L A Remo G M | 1993 | Life Sci1993，53，： | 1 |
| 9 | Colectomy is a risk factor for venous thromboembolism in ulcerative colitis显示文摘AIM: To compare venous thromboembolism(VTE) in hospitalized ulcerative colitis(UC) patients who respond to medical management to patients requiring colectomy. METHODS: Population-based surveillance from 1997 to 2009 was used to identify all adults admitted to hospital for a flare of UC and those patients who underwent colectomy. All medical charts were reviewed to confirm the diagnosis and extract clinically relevant information. UC patients were stratified by:(1) responsive to inpatient medical therapy(n = 382);(2) medically refractory requiring emergent colectomy(n = 309); and(3) elective colectomy(n = 329). The primary outcome was the development of VTE during hospitalization or within 6 mo of discharge. Heparin prophylaxis to prevent VTE was assessed. Logistic regression analysis determined the effect of disease course(i.e., responsive to medical therapy, medically refractory, and elective colectomy) on VTE after adjusting for confounders including age, sex, smoking, disease activity, comorbidities, extent of disease, and IBD medications(i.e., corticosteroids, mesalamine, azathioprine, and infliximab). Point estimates were presented as odds ratios(OR) with 95%CI.RESULTS: The prevalence of VTE among patients with UC who responded to medical therapy was 1.3% and only 16% of these patients received heparinprophylaxis. In contrast, VTE was higher among patients who underwent an emergent(8.7%) and elective(4.9%) colectomy, despite greater than 90% of patients receiving postoperative heparin prophylaxis. The most common site of VTE was intra-abdominal(45.8%) followed by lower extremity(19.6%). VTE was diagnosed after discharge from hospital in 16.7% of cases. Elective(adjusted OR = 3.69; 95%CI: 1.30-10.44) and emergent colectomy(adjusted OR = 5.28; 95%CI: 1.93-14.45) were significant risk factors for VTE as compared to medically responsive UC patients. Furthermore, the odds of a VTE significantly increased across time(adjusted OR = 1.10; 95%CI: 1.01-1.20). Age, sex, comorbidities, disease extent, disease activity, smoking, corticosteroids, mesalamine, azathioprine, and infliximab were not independently associated with the development of VTE. CONCLUSION: VTE was associated with colectomy, particularly, among UC patients who failed medical management. VTE prophylaxis may not be sufficient to prevent VTE in patients undergoing colectomy. | Gilaad G Kaplan Allen Lim Cynthia H Seow Gordon W Moran Subrata Ghosh Yvette Leung Jennifer Debruyn Geoffrey C Nguyen James Hubbard Remo Panaccione | 2015 | World Journal of Gastroenterology2015，21，4： | 0 |
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