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

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 effe...

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Autores principales: de Souza, Gláucio Silva, Vidigal, Fernando Mendonça, Chebli, Liliana Andrade, Ribeiro, Tarsila Campanha da Rocha, Furtado, Maria Cristina Vasconcellos, de Lima Pace, Fábio Heleno, de Miranda Chaves, Leonardo Duque, de Oliveira Zanini, Karine Andrade, Gaburri, Pedro Duarte, de Azevedo Lucca, Fernando, Zanini, Alexandre, Ribeiro, Luiz Cláudio, Chebli, Julio Maria Fonseca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762538/
https://www.ncbi.nlm.nih.gov/pubmed/23989915
http://dx.doi.org/10.12659/MSM.889196
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author de Souza, Gláucio Silva
Vidigal, Fernando Mendonça
Chebli, Liliana Andrade
Ribeiro, Tarsila Campanha da Rocha
Furtado, Maria Cristina Vasconcellos
de Lima Pace, Fábio Heleno
de Miranda Chaves, Leonardo Duque
de Oliveira Zanini, Karine Andrade
Gaburri, Pedro Duarte
de Azevedo Lucca, Fernando
Zanini, Alexandre
Ribeiro, Luiz Cláudio
Chebli, Julio Maria Fonseca
author_facet de Souza, Gláucio Silva
Vidigal, Fernando Mendonça
Chebli, Liliana Andrade
Ribeiro, Tarsila Campanha da Rocha
Furtado, Maria Cristina Vasconcellos
de Lima Pace, Fábio Heleno
de Miranda Chaves, Leonardo Duque
de Oliveira Zanini, Karine Andrade
Gaburri, Pedro Duarte
de Azevedo Lucca, Fernando
Zanini, Alexandre
Ribeiro, Luiz Cláudio
Chebli, Julio Maria Fonseca
author_sort de Souza, Gláucio Silva
collection PubMed
description 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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spelling pubmed-37625382013-09-04 Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients de Souza, Gláucio Silva Vidigal, Fernando Mendonça Chebli, Liliana Andrade Ribeiro, Tarsila Campanha da Rocha Furtado, Maria Cristina Vasconcellos de Lima Pace, Fábio Heleno de Miranda Chaves, Leonardo Duque de Oliveira Zanini, Karine Andrade Gaburri, Pedro Duarte de Azevedo Lucca, Fernando Zanini, Alexandre Ribeiro, Luiz Cláudio Chebli, Julio Maria Fonseca Med Sci Monit Product Investigations 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. International Scientific Literature, Inc. 2013-08-30 /pmc/articles/PMC3762538/ /pubmed/23989915 http://dx.doi.org/10.12659/MSM.889196 Text en © Med Sci Monit, 2013 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License
spellingShingle Product Investigations
de Souza, Gláucio Silva
Vidigal, Fernando Mendonça
Chebli, Liliana Andrade
Ribeiro, Tarsila Campanha da Rocha
Furtado, Maria Cristina Vasconcellos
de Lima Pace, Fábio Heleno
de Miranda Chaves, Leonardo Duque
de Oliveira Zanini, Karine Andrade
Gaburri, Pedro Duarte
de Azevedo Lucca, Fernando
Zanini, Alexandre
Ribeiro, Luiz Cláudio
Chebli, Julio Maria Fonseca
Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients
title Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients
title_full Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients
title_fullStr Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients
title_full_unstemmed Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients
title_short Effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal Crohn’s disease patients
title_sort effect of azathioprine or mesalazine therapy on incidence of re-hospitalization in sub-occlusive ileocecal crohn’s disease patients
topic Product Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762538/
https://www.ncbi.nlm.nih.gov/pubmed/23989915
http://dx.doi.org/10.12659/MSM.889196
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