Sustained Clinical Efficacy and Mucosal Healing of Thiopurine Maintenance Treatment in Ulcerative Colitis: A Real-Life Study

Daniela Pugliese, Annalisa Aratari, Stefano Festa, Pietro Manuel Ferraro, Rita Monterubbianesi, Luisa Guidi, Maria Lia Scribano, Claudio Papi, Alessandro Armuzzi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)4195968
JournalGastroenterology Research and Practice
Volume2018
DOIs
Publication statusPublished - 2018

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Ulcerative Colitis
Steroids
Therapeutics
Treatment Failure
Safety

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Sustained Clinical Efficacy and Mucosal Healing of Thiopurine Maintenance Treatment in Ulcerative Colitis : A Real-Life Study. / Pugliese, Daniela; Aratari, Annalisa; Festa, Stefano; Ferraro, Pietro Manuel; Monterubbianesi, Rita; Guidi, Luisa; Scribano, Maria Lia; Papi, Claudio; Armuzzi, Alessandro.

In: Gastroenterology Research and Practice, Vol. 2018, 2018, p. 4195968.

Research output: Contribution to journalArticle

Pugliese, Daniela ; Aratari, Annalisa ; Festa, Stefano ; Ferraro, Pietro Manuel ; Monterubbianesi, Rita ; Guidi, Luisa ; Scribano, Maria Lia ; Papi, Claudio ; Armuzzi, Alessandro. / Sustained Clinical Efficacy and Mucosal Healing of Thiopurine Maintenance Treatment in Ulcerative Colitis : A Real-Life Study. In: Gastroenterology Research and Practice. 2018 ; Vol. 2018. pp. 4195968.
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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.",
author = "Daniela Pugliese and Annalisa Aratari and Stefano Festa and Ferraro, {Pietro Manuel} and Rita Monterubbianesi and Luisa Guidi and Scribano, {Maria Lia} and Claudio Papi and Alessandro Armuzzi",
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T1 - Sustained Clinical Efficacy and Mucosal Healing of Thiopurine Maintenance Treatment in Ulcerative Colitis

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AU - Pugliese, Daniela

AU - Aratari, Annalisa

AU - Festa, Stefano

AU - Ferraro, Pietro Manuel

AU - Monterubbianesi, Rita

AU - Guidi, Luisa

AU - Scribano, Maria Lia

AU - Papi, Claudio

AU - Armuzzi, Alessandro

PY - 2018

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N2 - 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.

AB - 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.

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DO - 10.1155/2018/4195968

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