Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn's disease patients

被引:0
|
作者
de Souza, Glaucio Silva [1 ]
Vidigal, Fernando Mendonca [1 ]
Chebli, Liliana Andrade [2 ]
da Rocha Ribeiro, Tarsila Campanha [2 ]
Vasconcellos Furtado, Maria Cristina [1 ]
de Lima Pace, Fabio Heleno [2 ]
de Miranda Chaves, Leonardo Duque [2 ]
de Oliveira Zanini, Karine Andrade [2 ]
Gaburri, Pedro Duarte [2 ]
Lucca, Fernando de Azevedo [2 ]
Zanini, Alexandre [2 ]
Ribeiro, Luiz Claudio [2 ]
Fonseca Chebli, Julio Maria [2 ]
机构
[1] Univ Fed Juiz de Fora, Ctr Inflammatory Bowel Dis, Dept Surg, Juiz De Fora, Brazil
[2] Univ Fed Juiz de Fora, Ctr Inflammatory Bowel Dis, Dept Med, Div Gastroenterol, Juiz De Fora, Brazil
来源
MEDICAL SCIENCE MONITOR | 2013年 / 19卷
关键词
inflammatory bowel disease; Crohn's disease; hospitalization; surgery; azathioprine; mesalazine; INFLAMMATORY-BOWEL-DISEASE; DOUBLE-BLIND; COST; MANAGEMENT; OUTCOMES; SURGERY; ILLNESS;
D O I
暂无
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: Although the cost of Crohn's disease (CD) treatment differs considerably, hospitalization and surgery costs account for most of the total treatment cost. Decreasing hospitalization and surgery rates are pivotal issues in reducing health-care costs. Material/Methods: We evaluated the effect of azathioprine (AZA) compared with mesalazine on incidence of re-hospitalizations due to all causes and for CD-related surgeries. In this controlled, randomized study, 72 subjects with sub-occlusive ileocecal CD were randomized for AZA (2-3 mg/kg per day) or mesalazine (3.2 g per day) therapy during a 3-year period. The primary end point was the re-hospitalization proportion due to all causes, as well as for surgical procedures during this period evaluated between the groups. Results: On an intention-to-treat basis, the proportion of patients re-hospitalized within 36 months due to all causes was lower in patients treated with AZA compared to those on mesalazine (0.39 vs. 0.83, respectively; p=0.035). The AZA group had also significantly lower proportions of re-hospitalization for surgical intervention (0.25 vs. 0.56, respectively; p=0.011). The number of admissions (0.70 vs. 1.41, p=0.001) and the length of re-hospitalization (3.8 vs. 7.7 days; p=0.002) were both lower in AZA patients. Conclusions: Patients with sub-occlusive ileocecal CD treated with AZA had lower re-hospitalization rates due to all causes and for surgical management of CD compared to those treated with mesalazine during a 3-year period. The long-term use of AZA in ileocecal CD patients recovering from a sub-occlusion episode can save healthcare costs.
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收藏
页码:716 / 722
页数:7
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