Risk factors for thiopurine-related toxicity in Latin American inflammatory bowel disease patients

Belén Giacaman; Francisca Grandón; Magdalena Ibacache; Valeria Granzotto; José Miguel Ortega; Constanza Norambuena; Ignacia Sepúlveda; Tamara Pérez-Jéldres; Javier Chahuán; Manuel Álvarez-Lobos; Carolina Pavez; Cristian Hernandez-Rocha

doi:10.47892/rgp.2026.463.2237

Autores/as

Belén Giacaman Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. https://orcid.org/0009-0004-7509-5806
Francisca Grandón Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. https://orcid.org/0009-0006-7779-6272
Magdalena Ibacache Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. https://orcid.org/0009-0002-0026-747X
Valeria Granzotto Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. https://orcid.org/0009-0006-3393-2412
José Miguel Ortega Department of Medicine, Faculty of Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. https://orcid.org/0009-0007-2801-5561
Constanza Norambuena Department of Medicine, Faculty of Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. https://orcid.org/0000-0002-7561-9524
Ignacia Sepúlveda Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. https://orcid.org/0009-0006-3031-9452
Tamara Pérez-Jéldres Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Instituto de Medicina, Red Salud UC Christus, Santiago, Chile. https://orcid.org/0000-0003-4234-3813
Javier Chahuán Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Instituto de Medicina, Red Salud UC Christus, Santiago, Chile. https://orcid.org/0000-0003-1261-6200
Manuel Álvarez-Lobos Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Instituto de Medicina, Red Salud UC Christus, Santiago, Chile. https://orcid.org/0000-0002-1245-8479
Carolina Pavez Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Instituto de Medicina, Red Salud UC Christus, Santiago, Chile. https://orcid.org/0000-0002-7593-3652
Cristian Hernandez-Rocha Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Instituto de Medicina, Red Salud UC Christus, Santiago, Chile. https://orcid.org/0000-0001-9018-4242

DOI:

https://doi.org/10.47892/rgp.2026.463.2237

Palabras clave:

Inflammatory Bowel Diseases, Immunosuppressive Agents, Latin America

Resumen

Objectives: Thiopurines continue to play a role in inflammatory bowel disease (IBD) treatment, particularly in resource-limited countries. However, there are scarce data from Latin America regarding thiopurines-associated AE. We aim to describe the thiopurine-associated AE and determine risk factors for its occurrence. Materials and methods: Clinical data from IBD patients treated with thiopurines in a Chilean tertiary centre were retrospectively collected including AE that required thiopurine withdrawal and weight-based thiopurine dose. A multivariable model was fitted to determine independent risk factors of thiopurine-related AE. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. Results: A total 163 out of 587 (27.7%) patients discontinued thiopurine treatment due to AE including myelosuppression, hepatitis, pancreatitis, and gastrointestinal intolerance. Multivariate analysis showed that older age (OR: 1.02; 95% CI: 1.01-1.04; p=0.01) and lower body weight (OR: 0.97; 95% CI: 0.95-0.99; p=0.01) were independent risk factors for thiopurine-associated AE. Conclusions: Discontinuation of thiopurines due to AE is frequent in Latin IBD patients. Particular caution should be exerted in older and low-weight IBD patients starting thiopurine treatment.

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Citas

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