Efficacy of Thiopurines in Biologic-Naive Japanese Patients With Crohn's Disease: A Single-Center Experience.
- Author:
Takuya YOSHINO
1
;
Minoru MATSUURA
;
Naoki MINAMI
;
Satoshi YAMADA
;
Yusuke HONZAWA
;
Masamichi KIMURA
;
Yorimitsu KOSHIKAWA
;
Ali MADIAN
;
Takahiko TOYONAGA
;
Hiroshi NAKASE
Author Information
- Publication Type:Original Article
- Keywords: Thiopurine; Biologic-naive; Crohn disease
- MeSH: Asian Continental Ancestry Group*; Biological Products; Crohn Disease*; Humans; Immunologic Factors; Multivariate Analysis; Prevalence; Quality of Life; Recurrence
- From:Intestinal Research 2015;13(3):266-273
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Early use of biologics in patients with Crohn's disease (CD) improves quality of life. However, the effects of the early use of immunomodulators on long-term outcomes remain unclear. This study aimed to evaluate the effects of immunomodulators in patients with CD. METHODS: Between January 2004 and December 2011, 47 biologic-naive CD patients treated with thiopurines alone for remission maintenance were analyzed. The patients were classified into 2 groups depending on the presence or absence of digestive complications. We evaluated the efficacy of and predictive factors for thiopurine use for remission maintenance. RESULTS: The cumulative relapse rates at 24 and 60 months were 13.7% and 35.4%, respectively. Regarding patient characteristics, there was a significant difference in patient history of surgery between the non-relapse and relapse groups (P=0.021). The cumulative relapse rate was lower in patients without a history of surgery than in those with such a history (27.2% and 52.9% at 60.0 months, respectively). Multivariate analysis suggested that the prevalence of stricturing and penetrating complications is an independent factor for relapse. The cumulative relapse rate in patients without a history of surgery was significantly lower in the non-stricturing and non-penetrating group than in the stricturing and penetrating group (11.8% at 85.0 months vs. 58.5% at 69.0 months; P=0.036). CONCLUSIONS: Thiopurine use might be beneficial for the long-term maintenance of remission in biologic-naive Crohn's disease patients without digestive complications and a history of surgery.
