Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Outcome of concomitant treatment with thiopurines and allopurinol in patients with inflammatory bowel disease: A nationwide Danish cohort study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Health-related quality of life in inflammatory bowel disease in a Danish population-based inception cohort

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. The association of celiac disease and allergic disease in a general adult population

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Dietary risk factors for inflammatory bowel diseases in a high-risk population: Results from the Faroese IBD study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. The distribution of HLA DQ2 and DQ8 haplotypes and their association with health indicators in a general Danish population

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Body mass index in young men and risk of inflammatory bowel disease through adult life: A population-based Danish cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Changing epidemiology of immune-mediated inflammatory diseases in immigrants: A systematic review of population-based studies

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Incidence of Immune-mediated Inflammatory Diseases Among Patients With Inflammatory Bowel Diseases in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Phenome-wide association analysis of LDL-cholesterol lowering genetic variants in PCSK9

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Colorectal Cancer in Individuals With Familial Adenomatous Polyposis, Based on Analysis of the Danish Polyposis Registry

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Background: Thiopurine and allopurinol in combination are associated with clinical remission in inflammatory bowel diseases but their influence on subsequent outcomes is unclear. We compared outcomes during exposure to both thiopurines and allopurinol versus thiopurines alone. Methods: We established a nationwide cohort of patients with inflammatory bowel diseases exposed to thiopurines ± allopurinol during 1999–2014, using registry data. Patients were followed until hospitalization, surgery, anti-TNFα, or death (as a primary composite outcome). We used Poisson regression analyses to calculate incidence rate ratios overall and stratified by calendar period (assuming the combined exposure was unintended before 2009). Results: A total of 10,367 patients with inflammatory bowel diseases (Crohn's disease, n = 5484; ulcerative colitis, n = 4883) received thiopurines. Of these, 217 (2.1%) also received allopurinol. During 24,714 person years of follow-up, we observed 40 outcomes among thiopurine-allopurinol-exposed patients, and 4745 outcomes among those who were thiopurine exposed; incidence rate ratio, 1.26 (95% confidence interval, 0.92–1.73). The incidence rate ratios decreased over time: 4.88 (95% confidence interval 2.53–9.45) for 1999–2003, 2.19 (95% confidence interval, 1.17–4.09) for 2004–2008 and 0.80 (95% confidence interval, 0.52–1.23) for 2009–2014. Conclusion: Our nationwide inflammatory bowel disease cohort study shows that concomitant thiopurine-allopurinol is as safe to use as thiopurines alone, with a tendency towards a positive effect on clinical outcomes in recent calendar periods when combined use was intended.

Original languageEnglish
JournalUnited European Gastroenterology Journal
ISSN2050-6406
DOIs
Publication statusE-pub ahead of print - 1 Jan 2019

    Research areas

  • allopurinol, anti-TNFα, epidemiology, hospitalization, Inflammatory bowel disease, surgery, thiopurine

ID: 57959062