P317. The rate of drug usage and side-effects in inflammatory bowel disease
G. Can, A. Tezel, G. Ünsal, A. Üstündag, H. Ümit, A.R. Soylu, Trakya University Faculty of Medicine, Gastroenterology Department, Edirne, Turkey
Inflammatory bowel disease (IBD) is a chronic, progressive and inflammatory disease group. More effective drugs were needed over time in ulcerative colitis (UC) and Crohn's disease (CD) depending on the progressive course of diseases. Otherwise, the side effect profile of available treatment modalities decreases the compliance of patients to medication and treatment alternatives. In our study, we aimed to investigate the rate of drug usage and its side-effect profile in Trakya IBD population.
Totally 401 IBD patients (302 UC, 99 CD) followed up between 1999–2013 in Trakya University Gastroenterology Clinic were recruited to study. Clinical data was retrospectively evaluated in terms of IBD clinical characteristics, IBD associated drug usage and its side effects. Descriptive statistical analysis was made.
5-ASA usage rate is over 90% in both UC and CD. There was no 5-ASA enema usage in CD except two patients with colonic involvement. Generally, corticosteroid, azathioprine and antiTNFa usage is higher in CD than UC. Recurrent corticosteroid usage rate is similar in UC and CD (UC/CD; 0.87/0.85). The rate of side-effect of any IBD related drugs was 35% in CD, 27.1% in UC. Side effect rates of oral 5-ASA were higher in UC, but side effects rates of intravenous cortikosteroid and azathioprinde were in CD. The frequencies of side effect in other drug were similar. There was no side effect in antiTNFa inhibitor users. The most common side effect was hepatotoxicity with oral 5-ASA in UC, nephrotoxicity with oral 5-ASA in CD. The most frequently seen side effect was abdominal pain with 5-ASA enema inUC. In both diseases, osteoporosis and cushingoid appearance were the most encountered side effects with corticosteroids. The risk of hepatotoxicity and cytopenia with azathioprine was higher in UC, cytopenia and pancreatitis were the most common side effects with azathioprine in CD (Table 1).
|Ulcerative colitis||Crohn's disease|
|Drug usage, n (%)||Side effects, n (%)||Drug usage, n (%)||Side effects, n (%)|
|5-ASA (oral)||196 (93.3)||28 (14.3)||89 (90.8)||10 (11.3)|
|5-ASA (enema)||183 (87.1)||10 (5.5)||2 (2.0)||0 (0)|
|Corticosteroid (intravenous)||17 (8.7)||2 (11.7)||4 (4.0)||1 (25.0)|
|Corticosteroid (oral)||73 (34.6)||35 (47.3)||44 (44.9)||20 (47.6)|
|Corticosteroid (enema)||22 (10.4)||2 (9.1)||1 (1.0)||0 (0)|
|Corticosteroid (general)||85 (40.4)||37 (43.5)||44 (44.9)||20 (47.6)|
|Azathioprine||20 (9.5)||4 (20)||51 (52.0)||13 (25.5)|
|AntiTNFa inhibitors||9 (4.2)||0 (0)||19 (19.3)||0 (0)|
The requirement of immunosuppressives and antiTNFa inhibitors is at more higher rates in CD. CD is a more complicated and difficult to treat disease than UC. The side-effects of available drugs in IBD decrease the compliance of patients to medication and treatment alternatives. More potent drugs having a lower side effect rates are needed especially in CD.