The use of thiopurines for the treatment of inflammatory bowel diseases in clinical practice

S. Saibeni, T. Virgilio, R. D'Incà, L. Spina, A. Bortoli, M. Paccagnella, M. Peli, R. Sablich, G. Meucci, E. Colombo, G. Benedetti, C. M. Girelli, G. Casella, G. Grasso, R. de Franchis, M. Vecchi

Research output: Contribution to journalArticle

Abstract

Background: Thiopurines are the most commonly used immunomodulatory drugs in inflammatory bowel diseases. Aim: To evaluate the use, the therapeutic and safety profiles of thiopurines in a large sample of IBD patients. Methods: We reviewed 3641 case histories of IBD patients. Thiopurines were prescribed in 582 patients (16.0%); the analysis was performed on the 553 (267 ulcerative colitis, 286 Crohn's disease) with exhaustive clinical data. Results: The main indications for treatment were steroid-dependence (328/553, 59.3%) and steroid-resistance (113/553, 20.7%). Thiopurines were started when CD were younger than UC patients (p <0.001) but earlier from diagnosis in UC than in CD patients (p = 0.003). Efficacy was defined as optimal (258/553, 46.6%), partial (108/553, 19.5%), absent (85/553, 15.4%) and not assessable (102/553, 18.4%). Efficacy was independent of disease type, location/extension or duration and age at starting. Side effects were observed in 151/553 (27.3%) patients, leading to drug discontinuation in 101 (18.3%). 15 out of the 130 (11.5%) patients who took thiopurines for more than 4 years relapsed, more frequently in CD than in UC (OR = 3.67 95% C.I. 0.98-13.69; p = 0.053). Conclusions: Thiopurines confirm their clinical usefulness and acceptable safety profile in managing complicated IBD patients. The majority of patients treated for longer than 4 years maintain response. No clinical and demographic predictive factors for efficacy and side effects were identified.

Original languageEnglish
Pages (from-to)814-820
Number of pages7
JournalDigestive and Liver Disease
Volume40
Issue number10
DOIs
Publication statusPublished - Oct 2008

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Keywords

  • Inflammatory bowel diseases
  • Therapy
  • Thiopurines

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Saibeni, S., Virgilio, T., D'Incà, R., Spina, L., Bortoli, A., Paccagnella, M., Peli, M., Sablich, R., Meucci, G., Colombo, E., Benedetti, G., Girelli, C. M., Casella, G., Grasso, G., de Franchis, R., & Vecchi, M. (2008). The use of thiopurines for the treatment of inflammatory bowel diseases in clinical practice. Digestive and Liver Disease, 40(10), 814-820. https://doi.org/10.1016/j.dld.2008.03.016