Evidence map›Paper›PMID 32591969›Full record

ArticleDigestive diseases and sciences2021

Poor Drug Sustainability in Inflammatory Bowel Disease Patients in Clinical Remission on Thiopurine Monotherapy.

Bhairavi Balram, Joshua Lubov, Yves Theoret, Waqqas Afif, Alain Bitton, Gary Wild, Peter L Lakatos, Talat Bessissow

Abstract read
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Article in Digestive diseases and sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Heat-KilledNutrients · 2024
    Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Bhairavi BalramDepartment of Internal Medicine, McGill University Health Center, Rm D05.5840, 1001 Décarie Boulevard, Montreal, QC, H4A 3J1, Canada. bhairavi.balram@mail.mcgill.ca.ORCID 0000-0001-6267-9934
Joshua LubovDepartment of Internal Medicine, McGill University Health Center, Rm D05.5840, 1001 Décarie Boulevard, Montreal, QC, H4A 3J1, Canada.
Yves TheoretCentre Hospitalier Universitaire Sainte-Justine, Unité de Pharmacologie Clinique, Montreal, QC, H3T 1C5, Canada.
Waqqas AfifDivision of Gastroenterology, Montreal General Hospital, McGill University Health Center, 1650 Cedar Avenue, C7-200, Montreal, QC, H3G 1A4, Canada.
Alain BittonDivision of Gastroenterology, Montreal General Hospital, McGill University Health Center, 1650 Cedar Avenue, C7-200, Montreal, QC, H3G 1A4, Canada.
Gary WildDivision of Gastroenterology, Montreal General Hospital, McGill University Health Center, 1650 Cedar Avenue, C7-200, Montreal, QC, H3G 1A4, Canada.
Peter L LakatosDivision of Gastroenterology, Montreal General Hospital, McGill University Health Center, 1650 Cedar Avenue, C7-200, Montreal, QC, H3G 1A4, Canada.
Talat BessissowDivision of Gastroenterology, Montreal General Hospital, McGill University Health Center, 1650 Cedar Avenue, C7-200, Montreal, QC, H3G 1A4, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmunomodulator monotherapy is an important component in the treatment of inflammatory bowel disease (IBD). However, there is conflicting literature about thiopurines maintaining long-term remission in patients with active IBD.

aimTo determine the durable clinical remission rate in adults with Crohn's disease (CD) or ulcerative colitis (UC) on thiopurine monotherapy over 5 years.

methodsWe performed a retrospective analysis of adult patients identified at McGill University Health Centre from 2009 to 2012. We included IBD patients who initiated thiopurine monotherapy and were in remission for at least 3 months (Harvey-Bradshaw Index (HBI) < 5 points for CD and partial Mayo Score (pMS) < 2 points in UC). The primary endpoint was sustained clinical remission on thiopurines during a 5-year follow-up. This included patients who had not relapsed or discontinued the drug due to side effects. The secondary endpoint was clinical relapse over the follow-up period, which was defined as HBI > 5 in CD and pMS > 2 in UC.

resultsThere were 148 patients included in the study (100 CD; 48 UC). At 5 years, 23% (34/148) patients remained in clinical remission on thiopurine monotherapy (25 CD and 9 UC patients). Thirty-three percent (33/100) of CD and 46% (22/48) of UC patients relapsed while on thiopurines. There was no difference in relapse rates between CD and UC patients. Eighty-four percent (42/50) of patients with CD with side effects and all UC (17/17) patients who experienced side effects discontinued the drug.

conclusionThis analysis demonstrates that there is poor sustainability of clinical remission in IBD patients on thiopurine monotherapy given that a high proportion of patients discontinue thiopurines due to either relapse or side effects.

Indexed as

AdultAnti-Inflammatory AgentsAzathioprineColitis, UlcerativeCrohn DiseaseFemaleGastrointestinal AgentsHumansMaleMercaptopurineMiddle AgedQuebecRecurrenceRemission InductionRetrospective StudiesTime FactorsAnti-Inflammatory AgentsAzathioprineGastrointestinal AgentsMercaptopurineInflammatory bowel diseaseRelapse ratesSide effectsThiopurine monotherapy

Identifiers

PMID32591969

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.