Abstract:
Background and Aims:Thiopurines are commonly used for treating ulcerative colitis (UC), despite the fact that controlled evidence supporting their efficacy is limited. The aim of this study was to evaluate the long-term outcome of thiopurines as maintenance therapy in a large cohort of UC patients. Methods:All UC patients receiving thiopurine monotherapy at three tertiary IBD centers from 1995 to 2015 were identified. The primary endpoint was steroid-free clinical remission. Secondary endpoints were mucosal healing (MH), defined as Mayo endoscopic subscore 0, long-term safety, and predictors of sustained clinical remission. Results:We identified 192 patients, contributing a total of 747 person-years of follow-up (median follow-up 36 months, range 1-210 months). Steroid dependency was the most common indication for thiopurine treatment (58%). Steroid-free remission occurred in 45.3% of patients; 36.3% stopped thiopurines because of treatment failure and 18.2% for adverse events or intolerance. The cumulative probability of maintaining steroid-free remission while on thiopurine treatment was 87%, 76%, 67.6%, and 53.4% at 12, 24, 36, and 60 months, respectively. MH occurred in 57.9% of patients after a median of 18 months (range 5-96). No independent predictors of sustained clinical remission could be identified. Conclusions:Thiopurines represent an effective and safe long-term maintenance therapy for UC patients.
journal_name
Gastroenterol Res Practjournal_title
Gastroenterology research and practiceauthors
Pugliese D,Aratari A,Festa S,Ferraro PM,Monterubbianesi R,Guidi L,Scribano ML,Papi C,Armuzzi Adoi
10.1155/2018/4195968subject
Has Abstractpub_date
2018-10-03 00:00:00pages
4195968eissn
1687-6121issn
1687-630Xjournal_volume
2018pub_type
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journal_title:Gastroenterology research and practice
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