Finding Predictors of Azathioprine-Induced Pancreatitis in Patients With Inflammatory Bowel Disease. Issue 3 (March 2022)

• Record Type: Journal Article
• Authors: Freitas, Marta; Lima Capela, Tiago; Macedo Silva, Vítor; Arieira, Cátia; Cúrdia Gonçalves, Tiago; Dias de Castro, Francisca; Moreira, Maria João; Firmino-Machado, João; Cotter, José
• Is Part Of: Pancreas. Volume 51:Issue 3(2022)
• Page Start: 288
• Page End: 294
• Publication Date: 2022-03
• Subjects: azathioprine -- acute pancreatitis -- Crohn's disease -- ulcerative colitis -- inflammatory bowel disease -- budesonide; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000002012
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: Azathioprine (AZA)-induced pancreatitis (AIP) is a common, idiosyncratic adverse effect whose incidence and risk factors data in inflammatory bowel disease (IBD) patients are not fully clarified. We aimed to establish the incidence, clinical course and identify risk factors for AIP. Methods: A retrospective study including all IBD patients on AZA between January 2013 and July 2020 was conducted. Patients with AIP were considered. Results: Azathioprine-induced pancreatitis occurred in 33 patients (7.5%; 442 patients on AZA). The mean time receiving AZA until AIP was 25 days, with a mean dose of 88 mg. All patients had a mild course of disease, which resolved with suspension of AZA and with no complications. Smoking ( P = 0.02), single daily dose of AZA ( P < 0.001), and concomitant budesonide ( P = 0.001) were risk factors for AIP. In multivariate analysis, concomitant treatment with budesonide (odds ratio, 5.3; P = 0.002) and single daily dose of AZA (odds ratio, 3.8; P = 0.002) were the only predictors of AIP. Conclusions: Although AIP was a relatively common adverse effect, it presented a mild course in all patients. Smoking, concomitant use of budesonide, and single-dose regimen of AZA should be avoided in IBD patients treated with AZA.