Tacrolimus induces short‐term but not long‐term clinical response in inflammatory bowel disease
Summary Background Tacrolimus is a calcineurin inhibitor commonly used for prophylaxis of rejection in renal and liver transplantation. There are limited but favourable data regarding its possible use in patients with inflammatory bowel disease (IBD). Aims To evaluate the efficacy and safety of tacr...
Gespeichert in:
| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2020-05, Vol.51 (9), p.870-879 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 879 |
|---|---|
| container_issue | 9 |
| container_start_page | 870 |
| container_title | Alimentary pharmacology & therapeutics |
| container_volume | 51 |
| creator | Rodríguez‐Lago, Iago Castro‐Poceiro, Jesús Fernández‐Clotet, Agnès Mesonero, Francisco López‐Sanromán, Antonio López‐García, Alicia Márquez, Lucía Clos‐Parals, Ariadna Cañete, Fiorella Vicuña, Miren Nantes, Óscar Merino, Olga Matallana, Virginia Gordillo, Jordi Elorza, Ainara Vicente, Raquel Casanova, María José Ferreiro‐Iglesias, Rocío Pérez‐Galindo, Pablo Benítez, José Manuel Taxonera, Carlos García, María José Martín, Eduardo Aguirre, Urko Gisbert, Javier P. Rodríguez‐Lago, I. Elorza, A. Castro‐Poceiro, J. Fernández‐Clotet, A. Mesonero, F. López‐Sanromán, A. López‐García, A. Márquez, L. Clos‐Parals, A. Cañete, F. Vicuña, M. Nantes, O. Merino, O. Matallana, V. Gordillo, J. Vicente, R. Casanova, M. J. Gisbert, J. P. Ferreiro‐Iglesias, R. Pérez‐Galindo, P. Manuel Benítez, J. Taxonera, C. García, M. J. Martín, E. Aguirre, U. Calafat, M. Muñoz, F. Miquel‐Cusachs, J. O. Sáinz, E. |
| description | Summary
Background
Tacrolimus is a calcineurin inhibitor commonly used for prophylaxis of rejection in renal and liver transplantation. There are limited but favourable data regarding its possible use in patients with inflammatory bowel disease (IBD).
Aims
To evaluate the efficacy and safety of tacrolimus in patients with IBD in clinical practice.
Methods
We performed a retrospective, multicentre study in 22 centres in Spain. All adult patients who received oral tacrolimus for luminal or perianal IBD were included. Clinical response was assessed by Harvey‐Bradshaw index and partial Mayo score after 3 months. Perianal disease was evaluated by fistula drainage assessment.
Results
One hundred and forty‐three patients were included (mean age 38 years; 51% male; median disease duration 110 months). In ulcerative colitis (UC) (n = 58), the partial Mayo score decreased after 3 months from median 6 to 3 (P = 0.0001), whereas in Crohn's disease (CD) (n = 85), the Harvey‐Bradshaw index decreased after 3 months from median 9 to 7 (P = 0.011). In CD patients, blood tacrolimus concentrations during induction (>10 ng/mL vs |
| doi_str_mv | 10.1111/apt.15687 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2377987406</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2377987406</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3537-e3b15585dfc4d8d3d3434d5c4d4e42a60fabba43a0cfe7a5815ea260e8e3fad53</originalsourceid><addsrcrecordid>eNp1kM9KxDAQh4Mo7rp68AWk4EUPdZOmadPjsvgPFvSwnkuaTLVL2tSkZdmbj-Az-iRm7a4HwTAQZvjmx_AhdE7wDfFvKtruhrCEpwdoTGjCwgjT5BCNcZRkYcQJHaET51YY4yTF0TEa0YhwklE8RnIppDW6qnsXVI3qJbjAvRnbfX18dmDroOi7oDFdoE3zup9JXTWVFDqw4FrTOPCrvkot6lp0xm6CwqxBB6pyIBycoqNSaAdnu3-CXu5ul_OHcPF0_zifLUJJGU1DoAVhjDNVylhxRRWNaayYb2KII5HgUhSFiKnAsoRUME4YiCjBwIGWQjE6QVdDbmvNew-uy-vKSdBaNGB6l0c0TTOexjjx6OUfdGV62_jrPMUzQjLOt9T1QHlFzlko89ZWtbCbnOB8az735vMf85692CX2RQ3ql9yr9sB0ANaVhs3_SfnseTlEfgOvmJC8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2389119886</pqid></control><display><type>article</type><title>Tacrolimus induces short‐term but not long‐term clinical response in inflammatory bowel disease</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Rodríguez‐Lago, Iago ; Castro‐Poceiro, Jesús ; Fernández‐Clotet, Agnès ; Mesonero, Francisco ; López‐Sanromán, Antonio ; López‐García, Alicia ; Márquez, Lucía ; Clos‐Parals, Ariadna ; Cañete, Fiorella ; Vicuña, Miren ; Nantes, Óscar ; Merino, Olga ; Matallana, Virginia ; Gordillo, Jordi ; Elorza, Ainara ; Vicente, Raquel ; Casanova, María José ; Ferreiro‐Iglesias, Rocío ; Pérez‐Galindo, Pablo ; Benítez, José Manuel ; Taxonera, Carlos ; García, María José ; Martín, Eduardo ; Aguirre, Urko ; Gisbert, Javier P. ; Rodríguez‐Lago, I. ; Elorza, A. ; Castro‐Poceiro, J. ; Fernández‐Clotet, A. ; Mesonero, F. ; López‐Sanromán, A. ; López‐García, A. ; Márquez, L. ; Clos‐Parals, A. ; Cañete, F. ; Vicuña, M. ; Nantes, O. ; Merino, O. ; Matallana, V. ; Gordillo, J. ; Vicente, R. ; Casanova, M. J. ; Gisbert, J. P. ; Ferreiro‐Iglesias, R. ; Pérez‐Galindo, P. ; Manuel Benítez, J. ; Taxonera, C. ; García, M. J. ; Martín, E. ; Aguirre, U. ; Calafat, M. ; Muñoz, F. ; Miquel‐Cusachs, J. O. ; Sáinz, E.</creator><creatorcontrib>Rodríguez‐Lago, Iago ; Castro‐Poceiro, Jesús ; Fernández‐Clotet, Agnès ; Mesonero, Francisco ; López‐Sanromán, Antonio ; López‐García, Alicia ; Márquez, Lucía ; Clos‐Parals, Ariadna ; Cañete, Fiorella ; Vicuña, Miren ; Nantes, Óscar ; Merino, Olga ; Matallana, Virginia ; Gordillo, Jordi ; Elorza, Ainara ; Vicente, Raquel ; Casanova, María José ; Ferreiro‐Iglesias, Rocío ; Pérez‐Galindo, Pablo ; Benítez, José Manuel ; Taxonera, Carlos ; García, María José ; Martín, Eduardo ; Aguirre, Urko ; Gisbert, Javier P. ; Rodríguez‐Lago, I. ; Elorza, A. ; Castro‐Poceiro, J. ; Fernández‐Clotet, A. ; Mesonero, F. ; López‐Sanromán, A. ; López‐García, A. ; Márquez, L. ; Clos‐Parals, A. ; Cañete, F. ; Vicuña, M. ; Nantes, O. ; Merino, O. ; Matallana, V. ; Gordillo, J. ; Vicente, R. ; Casanova, M. J. ; Gisbert, J. P. ; Ferreiro‐Iglesias, R. ; Pérez‐Galindo, P. ; Manuel Benítez, J. ; Taxonera, C. ; García, M. J. ; Martín, E. ; Aguirre, U. ; Calafat, M. ; Muñoz, F. ; Miquel‐Cusachs, J. O. ; Sáinz, E. ; Young GETECCU Group ; the Young GETECCU Group</creatorcontrib><description>Summary
Background
Tacrolimus is a calcineurin inhibitor commonly used for prophylaxis of rejection in renal and liver transplantation. There are limited but favourable data regarding its possible use in patients with inflammatory bowel disease (IBD).
Aims
To evaluate the efficacy and safety of tacrolimus in patients with IBD in clinical practice.
Methods
We performed a retrospective, multicentre study in 22 centres in Spain. All adult patients who received oral tacrolimus for luminal or perianal IBD were included. Clinical response was assessed by Harvey‐Bradshaw index and partial Mayo score after 3 months. Perianal disease was evaluated by fistula drainage assessment.
Results
One hundred and forty‐three patients were included (mean age 38 years; 51% male; median disease duration 110 months). In ulcerative colitis (UC) (n = 58), the partial Mayo score decreased after 3 months from median 6 to 3 (P = 0.0001), whereas in Crohn's disease (CD) (n = 85), the Harvey‐Bradshaw index decreased after 3 months from median 9 to 7 (P = 0.011). In CD patients, blood tacrolimus concentrations during induction (>10 ng/mL vs <10 ng/mL; odds ratio 0.23, 95% CI 0.05‐0.87) and the concomitant use of thiopurines (odds ratio 0.18, 95% CI 0.04‐0.81) were associated with lower clinical disease activity at 3 months. Of 62 patients with perianal disease, complete closure was observed in 8% (n = 5) of patients with perianal fistulas, with 34% (n = 21) showing partial response. Treatment was maintained for a median of 6 months (IQR, 2‐16). After a median clinical follow‐up of 24 months (IQR, 15‐57), the rate of treatment‐related adverse events was 34%, correlating with blood drug concentrations (P = 0.021). Finally, 120 patients (84%) discontinued tacrolimus, usually due to absence or loss of response. Three patients (2%) were subsequently diagnosed with cancer. The overall rate of surgery was 39%, with a 33% colectomy rate in UC.
Conclusions
Tacrolimus shows a clinical benefit in both CD and UC after 3 months of treatment, but its long‐term effectiveness and frequent adverse events remain relevant issues in clinical practice.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.15687</identifier><identifier>PMID: 32181930</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Calcineurin ; Calcineurin inhibitors ; Clinical medicine ; Crohn's disease ; Fistulae ; Graft rejection ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Intestine ; Liver transplantation ; Patients ; Prophylaxis ; Surgery ; Tacrolimus ; Ulcerative colitis</subject><ispartof>Alimentary pharmacology & therapeutics, 2020-05, Vol.51 (9), p.870-879</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-e3b15585dfc4d8d3d3434d5c4d4e42a60fabba43a0cfe7a5815ea260e8e3fad53</citedby><cites>FETCH-LOGICAL-c3537-e3b15585dfc4d8d3d3434d5c4d4e42a60fabba43a0cfe7a5815ea260e8e3fad53</cites><orcidid>0000-0003-1133-4578 ; 0000-0003-2090-3445</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.15687$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.15687$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32181930$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodríguez‐Lago, Iago</creatorcontrib><creatorcontrib>Castro‐Poceiro, Jesús</creatorcontrib><creatorcontrib>Fernández‐Clotet, Agnès</creatorcontrib><creatorcontrib>Mesonero, Francisco</creatorcontrib><creatorcontrib>López‐Sanromán, Antonio</creatorcontrib><creatorcontrib>López‐García, Alicia</creatorcontrib><creatorcontrib>Márquez, Lucía</creatorcontrib><creatorcontrib>Clos‐Parals, Ariadna</creatorcontrib><creatorcontrib>Cañete, Fiorella</creatorcontrib><creatorcontrib>Vicuña, Miren</creatorcontrib><creatorcontrib>Nantes, Óscar</creatorcontrib><creatorcontrib>Merino, Olga</creatorcontrib><creatorcontrib>Matallana, Virginia</creatorcontrib><creatorcontrib>Gordillo, Jordi</creatorcontrib><creatorcontrib>Elorza, Ainara</creatorcontrib><creatorcontrib>Vicente, Raquel</creatorcontrib><creatorcontrib>Casanova, María José</creatorcontrib><creatorcontrib>Ferreiro‐Iglesias, Rocío</creatorcontrib><creatorcontrib>Pérez‐Galindo, Pablo</creatorcontrib><creatorcontrib>Benítez, José Manuel</creatorcontrib><creatorcontrib>Taxonera, Carlos</creatorcontrib><creatorcontrib>García, María José</creatorcontrib><creatorcontrib>Martín, Eduardo</creatorcontrib><creatorcontrib>Aguirre, Urko</creatorcontrib><creatorcontrib>Gisbert, Javier P.</creatorcontrib><creatorcontrib>Rodríguez‐Lago, I.</creatorcontrib><creatorcontrib>Elorza, A.</creatorcontrib><creatorcontrib>Castro‐Poceiro, J.</creatorcontrib><creatorcontrib>Fernández‐Clotet, A.</creatorcontrib><creatorcontrib>Mesonero, F.</creatorcontrib><creatorcontrib>López‐Sanromán, A.</creatorcontrib><creatorcontrib>López‐García, A.</creatorcontrib><creatorcontrib>Márquez, L.</creatorcontrib><creatorcontrib>Clos‐Parals, A.</creatorcontrib><creatorcontrib>Cañete, F.</creatorcontrib><creatorcontrib>Vicuña, M.</creatorcontrib><creatorcontrib>Nantes, O.</creatorcontrib><creatorcontrib>Merino, O.</creatorcontrib><creatorcontrib>Matallana, V.</creatorcontrib><creatorcontrib>Gordillo, J.</creatorcontrib><creatorcontrib>Vicente, R.</creatorcontrib><creatorcontrib>Casanova, M. J.</creatorcontrib><creatorcontrib>Gisbert, J. P.</creatorcontrib><creatorcontrib>Ferreiro‐Iglesias, R.</creatorcontrib><creatorcontrib>Pérez‐Galindo, P.</creatorcontrib><creatorcontrib>Manuel Benítez, J.</creatorcontrib><creatorcontrib>Taxonera, C.</creatorcontrib><creatorcontrib>García, M. J.</creatorcontrib><creatorcontrib>Martín, E.</creatorcontrib><creatorcontrib>Aguirre, U.</creatorcontrib><creatorcontrib>Calafat, M.</creatorcontrib><creatorcontrib>Muñoz, F.</creatorcontrib><creatorcontrib>Miquel‐Cusachs, J. O.</creatorcontrib><creatorcontrib>Sáinz, E.</creatorcontrib><creatorcontrib>Young GETECCU Group</creatorcontrib><creatorcontrib>the Young GETECCU Group</creatorcontrib><title>Tacrolimus induces short‐term but not long‐term clinical response in inflammatory bowel disease</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Tacrolimus is a calcineurin inhibitor commonly used for prophylaxis of rejection in renal and liver transplantation. There are limited but favourable data regarding its possible use in patients with inflammatory bowel disease (IBD).
Aims
To evaluate the efficacy and safety of tacrolimus in patients with IBD in clinical practice.
Methods
We performed a retrospective, multicentre study in 22 centres in Spain. All adult patients who received oral tacrolimus for luminal or perianal IBD were included. Clinical response was assessed by Harvey‐Bradshaw index and partial Mayo score after 3 months. Perianal disease was evaluated by fistula drainage assessment.
Results
One hundred and forty‐three patients were included (mean age 38 years; 51% male; median disease duration 110 months). In ulcerative colitis (UC) (n = 58), the partial Mayo score decreased after 3 months from median 6 to 3 (P = 0.0001), whereas in Crohn's disease (CD) (n = 85), the Harvey‐Bradshaw index decreased after 3 months from median 9 to 7 (P = 0.011). In CD patients, blood tacrolimus concentrations during induction (>10 ng/mL vs <10 ng/mL; odds ratio 0.23, 95% CI 0.05‐0.87) and the concomitant use of thiopurines (odds ratio 0.18, 95% CI 0.04‐0.81) were associated with lower clinical disease activity at 3 months. Of 62 patients with perianal disease, complete closure was observed in 8% (n = 5) of patients with perianal fistulas, with 34% (n = 21) showing partial response. Treatment was maintained for a median of 6 months (IQR, 2‐16). After a median clinical follow‐up of 24 months (IQR, 15‐57), the rate of treatment‐related adverse events was 34%, correlating with blood drug concentrations (P = 0.021). Finally, 120 patients (84%) discontinued tacrolimus, usually due to absence or loss of response. Three patients (2%) were subsequently diagnosed with cancer. The overall rate of surgery was 39%, with a 33% colectomy rate in UC.
Conclusions
Tacrolimus shows a clinical benefit in both CD and UC after 3 months of treatment, but its long‐term effectiveness and frequent adverse events remain relevant issues in clinical practice.</description><subject>Calcineurin</subject><subject>Calcineurin inhibitors</subject><subject>Clinical medicine</subject><subject>Crohn's disease</subject><subject>Fistulae</subject><subject>Graft rejection</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Intestine</subject><subject>Liver transplantation</subject><subject>Patients</subject><subject>Prophylaxis</subject><subject>Surgery</subject><subject>Tacrolimus</subject><subject>Ulcerative colitis</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kM9KxDAQh4Mo7rp68AWk4EUPdZOmadPjsvgPFvSwnkuaTLVL2tSkZdmbj-Az-iRm7a4HwTAQZvjmx_AhdE7wDfFvKtruhrCEpwdoTGjCwgjT5BCNcZRkYcQJHaET51YY4yTF0TEa0YhwklE8RnIppDW6qnsXVI3qJbjAvRnbfX18dmDroOi7oDFdoE3zup9JXTWVFDqw4FrTOPCrvkot6lp0xm6CwqxBB6pyIBycoqNSaAdnu3-CXu5ul_OHcPF0_zifLUJJGU1DoAVhjDNVylhxRRWNaayYb2KII5HgUhSFiKnAsoRUME4YiCjBwIGWQjE6QVdDbmvNew-uy-vKSdBaNGB6l0c0TTOexjjx6OUfdGV62_jrPMUzQjLOt9T1QHlFzlko89ZWtbCbnOB8az735vMf85692CX2RQ3ql9yr9sB0ANaVhs3_SfnseTlEfgOvmJC8</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Rodríguez‐Lago, Iago</creator><creator>Castro‐Poceiro, Jesús</creator><creator>Fernández‐Clotet, Agnès</creator><creator>Mesonero, Francisco</creator><creator>López‐Sanromán, Antonio</creator><creator>López‐García, Alicia</creator><creator>Márquez, Lucía</creator><creator>Clos‐Parals, Ariadna</creator><creator>Cañete, Fiorella</creator><creator>Vicuña, Miren</creator><creator>Nantes, Óscar</creator><creator>Merino, Olga</creator><creator>Matallana, Virginia</creator><creator>Gordillo, Jordi</creator><creator>Elorza, Ainara</creator><creator>Vicente, Raquel</creator><creator>Casanova, María José</creator><creator>Ferreiro‐Iglesias, Rocío</creator><creator>Pérez‐Galindo, Pablo</creator><creator>Benítez, José Manuel</creator><creator>Taxonera, Carlos</creator><creator>García, María José</creator><creator>Martín, Eduardo</creator><creator>Aguirre, Urko</creator><creator>Gisbert, Javier P.</creator><creator>Rodríguez‐Lago, I.</creator><creator>Elorza, A.</creator><creator>Castro‐Poceiro, J.</creator><creator>Fernández‐Clotet, A.</creator><creator>Mesonero, F.</creator><creator>López‐Sanromán, A.</creator><creator>López‐García, A.</creator><creator>Márquez, L.</creator><creator>Clos‐Parals, A.</creator><creator>Cañete, F.</creator><creator>Vicuña, M.</creator><creator>Nantes, O.</creator><creator>Merino, O.</creator><creator>Matallana, V.</creator><creator>Gordillo, J.</creator><creator>Vicente, R.</creator><creator>Casanova, M. J.</creator><creator>Gisbert, J. P.</creator><creator>Ferreiro‐Iglesias, R.</creator><creator>Pérez‐Galindo, P.</creator><creator>Manuel Benítez, J.</creator><creator>Taxonera, C.</creator><creator>García, M. J.</creator><creator>Martín, E.</creator><creator>Aguirre, U.</creator><creator>Calafat, M.</creator><creator>Muñoz, F.</creator><creator>Miquel‐Cusachs, J. O.</creator><creator>Sáinz, E.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1133-4578</orcidid><orcidid>https://orcid.org/0000-0003-2090-3445</orcidid></search><sort><creationdate>202005</creationdate><title>Tacrolimus induces short‐term but not long‐term clinical response in inflammatory bowel disease</title><author>Rodríguez‐Lago, Iago ; Castro‐Poceiro, Jesús ; Fernández‐Clotet, Agnès ; Mesonero, Francisco ; López‐Sanromán, Antonio ; López‐García, Alicia ; Márquez, Lucía ; Clos‐Parals, Ariadna ; Cañete, Fiorella ; Vicuña, Miren ; Nantes, Óscar ; Merino, Olga ; Matallana, Virginia ; Gordillo, Jordi ; Elorza, Ainara ; Vicente, Raquel ; Casanova, María José ; Ferreiro‐Iglesias, Rocío ; Pérez‐Galindo, Pablo ; Benítez, José Manuel ; Taxonera, Carlos ; García, María José ; Martín, Eduardo ; Aguirre, Urko ; Gisbert, Javier P. ; Rodríguez‐Lago, I. ; Elorza, A. ; Castro‐Poceiro, J. ; Fernández‐Clotet, A. ; Mesonero, F. ; López‐Sanromán, A. ; López‐García, A. ; Márquez, L. ; Clos‐Parals, A. ; Cañete, F. ; Vicuña, M. ; Nantes, O. ; Merino, O. ; Matallana, V. ; Gordillo, J. ; Vicente, R. ; Casanova, M. J. ; Gisbert, J. P. ; Ferreiro‐Iglesias, R. ; Pérez‐Galindo, P. ; Manuel Benítez, J. ; Taxonera, C. ; García, M. J. ; Martín, E. ; Aguirre, U. ; Calafat, M. ; Muñoz, F. ; Miquel‐Cusachs, J. O. ; Sáinz, E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-e3b15585dfc4d8d3d3434d5c4d4e42a60fabba43a0cfe7a5815ea260e8e3fad53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Calcineurin</topic><topic>Calcineurin inhibitors</topic><topic>Clinical medicine</topic><topic>Crohn's disease</topic><topic>Fistulae</topic><topic>Graft rejection</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Intestine</topic><topic>Liver transplantation</topic><topic>Patients</topic><topic>Prophylaxis</topic><topic>Surgery</topic><topic>Tacrolimus</topic><topic>Ulcerative colitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodríguez‐Lago, Iago</creatorcontrib><creatorcontrib>Castro‐Poceiro, Jesús</creatorcontrib><creatorcontrib>Fernández‐Clotet, Agnès</creatorcontrib><creatorcontrib>Mesonero, Francisco</creatorcontrib><creatorcontrib>López‐Sanromán, Antonio</creatorcontrib><creatorcontrib>López‐García, Alicia</creatorcontrib><creatorcontrib>Márquez, Lucía</creatorcontrib><creatorcontrib>Clos‐Parals, Ariadna</creatorcontrib><creatorcontrib>Cañete, Fiorella</creatorcontrib><creatorcontrib>Vicuña, Miren</creatorcontrib><creatorcontrib>Nantes, Óscar</creatorcontrib><creatorcontrib>Merino, Olga</creatorcontrib><creatorcontrib>Matallana, Virginia</creatorcontrib><creatorcontrib>Gordillo, Jordi</creatorcontrib><creatorcontrib>Elorza, Ainara</creatorcontrib><creatorcontrib>Vicente, Raquel</creatorcontrib><creatorcontrib>Casanova, María José</creatorcontrib><creatorcontrib>Ferreiro‐Iglesias, Rocío</creatorcontrib><creatorcontrib>Pérez‐Galindo, Pablo</creatorcontrib><creatorcontrib>Benítez, José Manuel</creatorcontrib><creatorcontrib>Taxonera, Carlos</creatorcontrib><creatorcontrib>García, María José</creatorcontrib><creatorcontrib>Martín, Eduardo</creatorcontrib><creatorcontrib>Aguirre, Urko</creatorcontrib><creatorcontrib>Gisbert, Javier P.</creatorcontrib><creatorcontrib>Rodríguez‐Lago, I.</creatorcontrib><creatorcontrib>Elorza, A.</creatorcontrib><creatorcontrib>Castro‐Poceiro, J.</creatorcontrib><creatorcontrib>Fernández‐Clotet, A.</creatorcontrib><creatorcontrib>Mesonero, F.</creatorcontrib><creatorcontrib>López‐Sanromán, A.</creatorcontrib><creatorcontrib>López‐García, A.</creatorcontrib><creatorcontrib>Márquez, L.</creatorcontrib><creatorcontrib>Clos‐Parals, A.</creatorcontrib><creatorcontrib>Cañete, F.</creatorcontrib><creatorcontrib>Vicuña, M.</creatorcontrib><creatorcontrib>Nantes, O.</creatorcontrib><creatorcontrib>Merino, O.</creatorcontrib><creatorcontrib>Matallana, V.</creatorcontrib><creatorcontrib>Gordillo, J.</creatorcontrib><creatorcontrib>Vicente, R.</creatorcontrib><creatorcontrib>Casanova, M. J.</creatorcontrib><creatorcontrib>Gisbert, J. P.</creatorcontrib><creatorcontrib>Ferreiro‐Iglesias, R.</creatorcontrib><creatorcontrib>Pérez‐Galindo, P.</creatorcontrib><creatorcontrib>Manuel Benítez, J.</creatorcontrib><creatorcontrib>Taxonera, C.</creatorcontrib><creatorcontrib>García, M. J.</creatorcontrib><creatorcontrib>Martín, E.</creatorcontrib><creatorcontrib>Aguirre, U.</creatorcontrib><creatorcontrib>Calafat, M.</creatorcontrib><creatorcontrib>Muñoz, F.</creatorcontrib><creatorcontrib>Miquel‐Cusachs, J. O.</creatorcontrib><creatorcontrib>Sáinz, E.</creatorcontrib><creatorcontrib>Young GETECCU Group</creatorcontrib><creatorcontrib>the Young GETECCU Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodríguez‐Lago, Iago</au><au>Castro‐Poceiro, Jesús</au><au>Fernández‐Clotet, Agnès</au><au>Mesonero, Francisco</au><au>López‐Sanromán, Antonio</au><au>López‐García, Alicia</au><au>Márquez, Lucía</au><au>Clos‐Parals, Ariadna</au><au>Cañete, Fiorella</au><au>Vicuña, Miren</au><au>Nantes, Óscar</au><au>Merino, Olga</au><au>Matallana, Virginia</au><au>Gordillo, Jordi</au><au>Elorza, Ainara</au><au>Vicente, Raquel</au><au>Casanova, María José</au><au>Ferreiro‐Iglesias, Rocío</au><au>Pérez‐Galindo, Pablo</au><au>Benítez, José Manuel</au><au>Taxonera, Carlos</au><au>García, María José</au><au>Martín, Eduardo</au><au>Aguirre, Urko</au><au>Gisbert, Javier P.</au><au>Rodríguez‐Lago, I.</au><au>Elorza, A.</au><au>Castro‐Poceiro, J.</au><au>Fernández‐Clotet, A.</au><au>Mesonero, F.</au><au>López‐Sanromán, A.</au><au>López‐García, A.</au><au>Márquez, L.</au><au>Clos‐Parals, A.</au><au>Cañete, F.</au><au>Vicuña, M.</au><au>Nantes, O.</au><au>Merino, O.</au><au>Matallana, V.</au><au>Gordillo, J.</au><au>Vicente, R.</au><au>Casanova, M. J.</au><au>Gisbert, J. P.</au><au>Ferreiro‐Iglesias, R.</au><au>Pérez‐Galindo, P.</au><au>Manuel Benítez, J.</au><au>Taxonera, C.</au><au>García, M. J.</au><au>Martín, E.</au><au>Aguirre, U.</au><au>Calafat, M.</au><au>Muñoz, F.</au><au>Miquel‐Cusachs, J. O.</au><au>Sáinz, E.</au><aucorp>Young GETECCU Group</aucorp><aucorp>the Young GETECCU Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tacrolimus induces short‐term but not long‐term clinical response in inflammatory bowel disease</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2020-05</date><risdate>2020</risdate><volume>51</volume><issue>9</issue><spage>870</spage><epage>879</epage><pages>870-879</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background
Tacrolimus is a calcineurin inhibitor commonly used for prophylaxis of rejection in renal and liver transplantation. There are limited but favourable data regarding its possible use in patients with inflammatory bowel disease (IBD).
Aims
To evaluate the efficacy and safety of tacrolimus in patients with IBD in clinical practice.
Methods
We performed a retrospective, multicentre study in 22 centres in Spain. All adult patients who received oral tacrolimus for luminal or perianal IBD were included. Clinical response was assessed by Harvey‐Bradshaw index and partial Mayo score after 3 months. Perianal disease was evaluated by fistula drainage assessment.
Results
One hundred and forty‐three patients were included (mean age 38 years; 51% male; median disease duration 110 months). In ulcerative colitis (UC) (n = 58), the partial Mayo score decreased after 3 months from median 6 to 3 (P = 0.0001), whereas in Crohn's disease (CD) (n = 85), the Harvey‐Bradshaw index decreased after 3 months from median 9 to 7 (P = 0.011). In CD patients, blood tacrolimus concentrations during induction (>10 ng/mL vs <10 ng/mL; odds ratio 0.23, 95% CI 0.05‐0.87) and the concomitant use of thiopurines (odds ratio 0.18, 95% CI 0.04‐0.81) were associated with lower clinical disease activity at 3 months. Of 62 patients with perianal disease, complete closure was observed in 8% (n = 5) of patients with perianal fistulas, with 34% (n = 21) showing partial response. Treatment was maintained for a median of 6 months (IQR, 2‐16). After a median clinical follow‐up of 24 months (IQR, 15‐57), the rate of treatment‐related adverse events was 34%, correlating with blood drug concentrations (P = 0.021). Finally, 120 patients (84%) discontinued tacrolimus, usually due to absence or loss of response. Three patients (2%) were subsequently diagnosed with cancer. The overall rate of surgery was 39%, with a 33% colectomy rate in UC.
Conclusions
Tacrolimus shows a clinical benefit in both CD and UC after 3 months of treatment, but its long‐term effectiveness and frequent adverse events remain relevant issues in clinical practice.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32181930</pmid><doi>10.1111/apt.15687</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1133-4578</orcidid><orcidid>https://orcid.org/0000-0003-2090-3445</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2020-05, Vol.51 (9), p.870-879 |
| issn | 0269-2813 1365-2036 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2377987406 |
| source | Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals |
| subjects | Calcineurin Calcineurin inhibitors Clinical medicine Crohn's disease Fistulae Graft rejection Inflammatory bowel disease Inflammatory bowel diseases Intestine Liver transplantation Patients Prophylaxis Surgery Tacrolimus Ulcerative colitis |
| title | Tacrolimus induces short‐term but not long‐term clinical response in inflammatory bowel disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T03%3A56%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Tacrolimus%20induces%20short%E2%80%90term%20but%20not%20long%E2%80%90term%20clinical%20response%20in%20inflammatory%20bowel%20disease&rft.jtitle=Alimentary%20pharmacology%20&%20therapeutics&rft.au=Rodr%C3%ADguez%E2%80%90Lago,%20Iago&rft.aucorp=Young%20GETECCU%20Group&rft.date=2020-05&rft.volume=51&rft.issue=9&rft.spage=870&rft.epage=879&rft.pages=870-879&rft.issn=0269-2813&rft.eissn=1365-2036&rft_id=info:doi/10.1111/apt.15687&rft_dat=%3Cproquest_cross%3E2377987406%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2389119886&rft_id=info:pmid/32181930&rfr_iscdi=true |