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首页> 外文期刊>Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association >Sustained clinical benefit and tolerability of methotrexate monotherapy after thiopurine therapy in patients with Crohn's disease.
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Sustained clinical benefit and tolerability of methotrexate monotherapy after thiopurine therapy in patients with Crohn's disease.

机译：克罗恩病患者接受硫嘌呤治疗后甲氨蝶呤单一疗法的持续临床获益和耐受性。

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Methotrexate is an immunosuppressant that is used to treat patients with Crohn's disease (CD). However, there are few data on the long-term effects of methotrexate maintenance therapy for these patients. We assessed the sustained clinical benefits and tolerability of methotrexate monotherapy after thiopurine therapy in patients with CD.We analyzed data from 3 hospitals on 174 consecutive patients with CD (age, 35 ± 12 y) who received methotrexate monotherapy after thiopurine therapy (23% also did not respond to anti-tumor necrosis factor therapy) from 2000 to 2010. We assessed patient characteristics and the tolerability and sustained clinical benefits of the treatment. Sustained clinical benefit was defined as ongoing use of methotrexate or intentional discontinuation of successful therapy before the end-of-study point.The number of patients with sustained clinical benefits from methotrexate monotherapy were 98 (86%), 50 (63%), 27 (47%), and 3 (20%), at 6, 12, 24, and 60 months, respectively. Forty-five patients (26%) discontinued methotrexate because of intolerance, particularly within 6 months after therapy began. Adverse responses generally were mild; only 1 patient required admission to the hospital for infection with cytomegalovirus, and no drug-related deaths were reported. Intolerance of the preceding thiopurine therapy was associated with adverse events during methotrexate therapy.In a large cohort study of patients who received methotrexate monotherapy after thiopurine therapy for CD, 47% continued to receive the therapy or intentionally discontinued successful therapy within 2 years, and 20% did so within 5 years. Long-term use of methotrexate was well tolerated and relatively safe.
机译：甲氨蝶呤是一种免疫抑制剂，用于治疗克罗恩氏病（CD）的患者。但是，关于氨甲蝶呤维持治疗对这些患者的长期影响的数据很少。我们评估了硫嘌呤治疗后CD患者甲氨蝶呤单一疗法的持续临床获益和耐受性。我们分析了3所医院的174例连续CD患者（年龄35±12岁）接受硫嘌呤治疗后甲氨蝶呤单一疗法的数据（也占23％）在2000年至2010年期间未对抗肿瘤坏死因子疗法产生反应。我们评估了患者的特征以及该疗法的耐受性和持续的临床益处。持续的临床获益被定义为在研究​​结束之前持续使用甲氨蝶呤或有意中止成功治疗的患者。接受甲氨蝶呤单一疗法持续临床获益的患者人数为98（86％），50（63％），27 （47％）和3（20％），分别位于第6、12、24和60个月。四十五名患者（26％）由于不耐受而停用甲氨蝶呤，尤其是在开始治疗后的六个月内。不良反应一般较轻。只有1名患者因巨细胞病毒感染而需要住院治疗，并且没有报道与药物相关的死亡。先前的硫嘌呤治疗的不耐受性与甲氨蝶呤治疗期间的不良事件有关。在一项大型队列研究中，在接受硫嘌呤CD治疗后接受甲氨蝶呤单药治疗的患者中，有47％的患者在2年内继续接受治疗或有意中止成功治疗，其中20 ％在5年内这样做。长期服用甲氨蝶呤耐受性好且相对安全。

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