title: Combination of infliximab with thiopurines significantly reduces white cell and neutrophil counts in inflammatory bowel disease patients.
abstract: BACKGROUND
  The effects of thiopurines on white cell count are well documented.
  
  
  OBJECTIVE
  We compared the effects of infliximab 5 mg/kg monotherapy and combination of infliximab with thiopurines on the total and differential white cell count (WBC).
  
  
  METHODS
  13 IBD patients treated with infliximab monotherapy and 18 IBD patients treated with a combination of infliximab and thiopurines were included in the study. Using retrospective data, cell counts were examined prior to induction of infliximab, and at 6 weeks and 1 year post-induction.
  
  
  RESULTS
  The patients on combination therapy had an absolute WBC at 52 weeks of 5.7 whereas that of patients on Infliximab monotherapy at the same time point was 8.3 with comparable neutrophil count of 3.4 and 5.4. The results showed a significant reduction in white cell count and neutrophils at 6 weeks which persisted at 52 weeks in both groups (p < 0.05) with a greater drop in patients on combination infliximab and thiopurine (p < 0.05) as compared to Infliximab monotherapy. There was no significant change in the lymphocyte count.
  
  
  CONCLUSIONS
  Full blood counts should be closely monitored in all patients starting infliximab therapy, in particular patients receiving concomitant thiopurines.
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland. vikpar37@ahoo.com.
authors.forename: V
authors.initials: V
authors.lastname: Parihar
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: O
authors.initials: O
authors.lastname: Maceneaney
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: Maguire
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Garry
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: O'Sullivan
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Kennedy
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: Safaya
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Smyth
authors.affiliation: Department of Gastroenterology, Connolly Hospital, Blanchardstown, Dublin-15, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Farrell
mesh_terms: D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage*; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000069285:Infliximab; D015122:Mercaptopurine; D001379:Azathioprine
keywords: Inflammatory bowel disease; Infliximab; Neutrophils; Thiopurines; White cell count