Dataset Information

Outcome of concomitant treatment with thiopurines and allopurinol in patients with inflammatory bowel disease: A nationwide Danish cohort study.

ABSTRACT:

Background

Thiopurine and allopurinol in combination are associated with clinical remission in inflammatory bowel diseases but their influence on subsequent outcomes is unclear. We compared outcomes during exposure to both thiopurines and allopurinol versus thiopurines alone.

Methods

We established a nationwide cohort of patients with inflammatory bowel diseases exposed to thiopurines?±?allopurinol during 1999-2014, using registry data. Patients were followed until hospitalization, surgery, anti-TNF?, or death (as a primary composite outcome). We used Poisson regression analyses to calculate incidence rate ratios overall and stratified by calendar period (assuming the combined exposure was unintended before 2009).

Results

A total of 10,367 patients with inflammatory bowel diseases (Crohn's disease, n?=?5484; ulcerative colitis, n?=?4883) received thiopurines. Of these, 217 (2.1%) also received allopurinol. During 24,714 person years of follow-up, we observed 40 outcomes among thiopurine-allopurinol-exposed patients, and 4745 outcomes among those who were thiopurine exposed; incidence rate ratio, 1.26 (95% confidence interval, 0.92-1.73). The incidence rate ratios decreased over time: 4.88 (95% confidence interval 2.53-9.45) for 1999-2003, 2.19 (95% confidence interval, 1.17-4.09) for 2004-2008 and 0.80 (95% confidence interval, 0.52-1.23) for 2009-2014.

Conclusion

Our nationwide inflammatory bowel disease cohort study shows that concomitant thiopurine-allopurinol is as safe to use as thiopurines alone, with a tendency towards a positive effect on clinical outcomes in recent calendar periods when combined use was intended.

SUBMITTER: Thomsen SB

PROVIDER: S-EPMC7006001 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Outcome of concomitant treatment with thiopurines and allopurinol in patients with inflammatory bowel disease: A nationwide Danish cohort study.

Thomsen Sandra Bohn SB Allin Kristine Højgaard KH Burisch Johan J Jensen Camilla Bjørn CB Hansen Susanne S Gluud Lise Lotte LL Theede Klaus K Kiszka-Kanowitz Marianne M Nielsen Anette Mertz AM Jess Tine T

United European gastroenterology journal 20190803 1

<h4>Background</h4>Thiopurine and allopurinol in combination are associated with clinical remission in inflammatory bowel diseases but their influence on subsequent outcomes is unclear. We compared outcomes during exposure to both thiopurines and allopurinol versus thiopurines alone.<h4>Methods</h4>We established a nationwide cohort of patients with inflammatory bowel diseases exposed to thiopurines ± allopurinol during 1999-2014, using registry data. Patients were followed until hospitalization ...[more]

PMID: 32213059

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Dataset Information

Outcome of concomitant treatment with thiopurines and allopurinol in patients with inflammatory bowel disease: A nationwide Danish cohort study.

Background

Methods

Results

Conclusion

Publications

Outcome of concomitant treatment with thiopurines and allopurinol in patients with inflammatory bowel disease: A nationwide Danish cohort study.

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