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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...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2013
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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. |
format | Online Article Text |
id | pubmed-3762538 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
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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