| Title: |
Thiopurine monotherapy is effective in ulcerative colitis but significantly less so in Crohn's disease: long-term outcomes for 11928 patients in the UK inflammatory bowel disease bioresource |
| Authors: |
Stournaras, Evangelos; Qian, Wendi; Pappas, Apostolos; Hong, You Yi; Shawky, Rasha; UK IBD BioResource Investigators; Raine, Tim; Parkes, Miles |
| Contributors: |
Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.; Steed, Helen; Brookes, Matthew |
| Source: |
70 ; 4 ; 677 ; 686 |
| Publisher Information: |
BMJ |
| Publication Year: |
2020 |
| Collection: |
University of Wolverhampton: Wolverhampton Intellectual Repository and E-Theses (WIRE) |
| Subject Terms: |
thiopurine monotherapy; ulcerative colitis; Crohn's disease; UK IBD BioResource; Humans; Colitis; Ulcerative; Crohn Disease; Azathioprine; Gastrointestinal Agents; Retrospective Studies; Adult; Female; Male; United Kingdom; Mercaptopurine; Outcome Assessment; Health Care |
| Description: |
�� 2020 The Authors. Published by BMJ. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher���s website: http://dx.doi.org/10.1136/gutjnl-2019-320185 ; Objective Thiopurines are widely used as maintenance therapy in inflammatory bowel disease (IBD) but the evidence base for their use is sparse and their role increasingly questioned. Using the largest series reported to date, we assessed the long-term effectiveness of thiopurines in ulcerative colitis (UC) and Crohn���s disease (CD), including their impact on need for surgery. Design Outcomes were assessed in 11���928 patients (4968 UC, 6960���CD) in the UK IBD BioResource initiated on thiopurine monotherapy with the intention of maintaining medically induced remission. Effectiveness was assessed retrospectively using patient-level data and a definition that required avoidance of escalation to biological therapy or surgery while on thiopurines. Analyses included overall effectiveness, time-to-event analysis for treatment escalation and comparison of surgery rates in patients tolerant or intolerant of thiopurines. Results Using 68���132 patient-years of exposure, thiopurine monotherapy appeared effective for the duration of treatment in 2617/4968 (52.7%) patients with UC compared with 2378/6960 (34.2%) patients with CD (p |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://gut.bmj.com/content/70/4/677; 33004550 (pubmed); http://hdl.handle.net/2436/624830; Gut |
| DOI: |
10.1136/gutjnl-2019-320185 |
| Availability: |
http://hdl.handle.net/2436/624830; https://doi.org/10.1136/gutjnl-2019-320185 |
| Rights: |
Licence for published version: Creative Commons Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.8A7EDEBA |
| Database: |
BASE |