Efficacy and Safety of Long-Term Thiopurine Maintenance Treatment in Japanese Patients With Ulcerative Colitis

• Published in: Intestinal research 2015, 13(3), , pp.250-258
• Main Authors: Yamada, Satoshi, Yoshino, Takuya, Matsuura, Minoru, Kimura, Masamichi, Koshikawa, Yorimitsu, Minami, Naoki, Toyonaga, Takahiko, Honzawa, Yusuke, Nakase, Hiroshi
• Format: Article
• Language: English
• Subjects: Colitis, ulcerative; Maintenance treatment; Original; Thiopurine; 내과학
• ISSN: 1598-9100; 2288-1956
• DOI: 10.5217/ir.2015.13.3.250

Background/AimsThe long-term clinical outcomes of patients with bio-naive ulcerative colitis (UC) who maintain remission with thiopurine are unclear. The aim of this study was to assess the long-term efficacy and safety of maintenance treatment with thiopurine in UC patients.MethodsThis was a retrospective observational cohort analysis conducted at a single center. Between December 1998 and August 2013, 59 of 87 patients with bio-naive UC who achieved remission after induction with treatments other than biologics were enrolled. Remission maintenance with thiopurine was defined as no concomitant treatment needed other than 5-aminosalicylate without relapse. We assessed the remission-maintenance rate, mucosal healing rate, colectomy-free rate, and treatment safety in UC patients who received thiopurine as maintenance treatment.ResultsThe 84-month cumulative remission-maintenance and colectomy-free survival rates in the UC patients who were receiving maintenance treatment with thiopurine and 5-aminosalicylate were 43.9% and 88.0%, respectively. Of the 38 patients who underwent colonoscopy during thiopurine maintenance treatment, 23 (60.5%) achieved mucosal healing. Of the 59 patients who achieved clinical remission with thiopurine, 6 patients (10.2%) discontinued the thiopurine therapy because of adverse events.ConclusionsOur study demonstrates the long-term efficacy and safety of thiopurine treatment in patients with bio-naive UC.