Thiopurine withdrawal during sustained clinical remission in inflammatory bowel disease: relapse and recapture rates, with predictive factors in 237 patients.
Bottom Line: Relapse rate at 12 months was significantly higher in CD than UC (P = 0.035).Elevated CRP at withdrawal was associated with higher relapse rates at 12 months for CD (P = 0.005), while an elevated white cell count was predictive at 12 months for UC (P = 0.007).Thiopurine withdrawal in the context of sustained remission is associated with a 1-year moderate-to-severe relapse rate of 23% in Crohn's disease and 12% in ulcerative colitis.
Affiliation: Gastrointestinal Unit, Western General Hospital, Edinburgh, UK.Show MeSH
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Mentions: Disease location and the most significant univariable laboratory parameters (haemoglobin, white cell count and CRP) were included in multivariable models for CD and UC. The Cox proportional hazards method was used to create a model to assess the contribution of each variable to risk of relapse. After backwards stepwise exclusion of variables that did not contribute to the model, WCC and CRP remained for CD, and only WCC remained for UC (Table5). Thresholds were then found to allow stratification of patients at higher and lower risk, and to allow creation of survival curves (Figure2).
Affiliation: Gastrointestinal Unit, Western General Hospital, Edinburgh, UK.