Early thiopurine maintenance is associated with reduced proximal disease progression and colectomy rate in ulcerative colitis

Background Thiopurines effectively maintain remission in ulcerative colitis patients. Whether early initiation of thiopurines after ulcerative colitis diagnosis decreases proximal disease progression and colectomy rates is not known. Methods We conducted a cohort study of ulcerative colitis subjects recruited from 1970 to 2009. Early thiopurine maintenance was defined as commencement of azathioprine or mercaptopurine within 5 years of diagnosis and maintenance for at least 6 months. Propensity score matching was conducted to correct for confounders influencing early thiopurine introduction. Outcomes of interest were colectomy rate and endoscopic proximal disease extension. Results 982 consecutive ulcerative colitis subjects (12 879 patient-years) were recruited with 116 requiring colectomy. Thiopurines initiation and maintenance increased over time with median time to thiopurine commencement decreasing from 23 years in the first decade to 2 years in the last decade (P 6 months is significantly associated with reduced colectomy and proximal progression of disease extent in ulcerative colitis.
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Original articles: Gastroenterology Source Type: research