P301 Relapse rates after withdrawal of thiopurines in patients with Inflammatory Bowel Disease

Autor: M K Ranjan, S K Vuyyuru, B Kante, P Kumar, S K Mundhra, R Golla, R Sharma, P Sahni, P Das, G Makharia, S Kedia, V Ahuja
Rok vydání: 2022
Předmět:
Zdroj: Journal of Crohn's and Colitis. 16:i330-i331
ISSN: 1876-4479
1873-9946
DOI: 10.1093/ecco-jcc/jjab232.428
Popis: Background Withdrawal of thiopurines after remission has been shown to be associated with an increased risk of relapse in patients with inflammatory bowel disease. However, long-term data on thiopurine withdrawal is limited especially from developing countries. Methods We retrospectively analyzed data of patients with IBD on thiopurine monotherapy who had stopped and were not on any other immunomodulator or biologics at the time of stopping thiopurines. All these were in clinical remission at the time of withdrawal. Results Among, 1264 patients of IBD who were treated with thiopurines, a total of, 461 patients had to stop thiopurine because of various reasons. Among these, 218 (UC=179; CD=39) patients were eligible for further study (Table-1). Overall, 36.7% (n=80) had relapsed after a median duration of months of, 20 months (IQR:, 9–49). There was no difference in relapse rate between UC and CD (39.6% vs, 23%; P:, 0.055). The overall cumulative probabilities of relapse were, 17%, 34%, and, 44% at the end of, 1, 3, and, 5 years respectively (Figure-1). The cumulative probabilities of relapse at, 1, 3, and, 5 years after thiopurine withdrawal were significantly lower in patients who had received azathioprine for at least, 48 months (14%, 20%, and, 31%) in comparison to those who had received for less than, 48 months (28%, 45%, and, 54%) respectively (P=0.007) (Figure-2). On multivariate Cox regression analysis, male sex [(HR:, 1.7 (1.1–2.7), P=0.014] and short duration of therapy with thiopurines [HR:, 0.98 (0.98–0.99), P=0.003] before withdrawal were associated with increased risk of relapse (Table-2). Conclusion Approximately, 50% of patients with IBD will relapse within, 5 years of thiopurine withdrawal. Male sex and shorter treatment duration (
Databáze: OpenAIRE
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