Adding Thiopurine After Loss of Response to Infliximab Versus Early Combination in Treating Crohn’s Disease: A Retrospective Study

Keizo Zeze, Atsushi Hirano, Takehiro Torisu, Motohiro Esaki, Tomohiko Moriyama, Junji Umeno, Keisuke Kawasaki, Shin Fujioka, Yuta Fuyuno, Yuichi Matsuno, Takanari Kitazono

研究成果: Contribution to journalArticle査読

2 被引用数 (Scopus)

抄録

Background: Although combining thiopurine with infliximab (IFX) is considered to improve the clinical efficacy of IFX when treating Crohn’s disease (CD), it also increases the risk of adverse events (AEs). We compared the efficacy and safety of delayed thiopurine addition after loss of response (LOR) to IFX with the efficacy and safety of an earlier combination of thiopurine and IFX. Methods: This retrospective study analyzed patients with CD who started IFX as a first-line biologic at Kyushu University Hospital between June 2002 and July 2018. Patients were assigned to either the early-combination (EC) group, who started IFX and thiopurine simultaneously, or the late-combination (LC) group, who were treated with IFX alone until they developed LOR. We compared the cumulative IFX continuation rates and AE incidence between the two groups. Results: One hundred seventy-six patients were enrolled in this study; 49 were enrolled in the EC group, and 127 were enrolled in the LC group. Disease activity at baseline did not significantly differ between the groups, nor did the cumulative IFX continuation rates differ between the groups (P = 0.30); however, the AE rate was significantly higher in the EC group than in the LC group (38.7% vs. 21.2%; P = 0.02). The severe AE rate was also higher in the EC group than in the LC group (18.3% vs 3.1%; P = 0.001). Conclusion: Considering the risk–benefit balance, delayed addition of thiopurine after LOR to IFX might be an alternative strategy when using IFX to treat CD.

本文言語英語
ページ(範囲)3124-3131
ページ数8
ジャーナルDigestive Diseases and Sciences
66
9
DOI
出版ステータス出版済み - 9 2021
外部発表はい

All Science Journal Classification (ASJC) codes

  • 生理学
  • 消化器病学

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