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Postoperative Effects of Thiopurines in Patients with Intestinal Behçet’s Disease

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Abstract

Background

No studies have heretofore specifically focused on the efficacy of postoperative thiopurine therapy in intestinal Behçet’s disease (BD). We conducted this study to assess the clinical effects of postoperative thiopurines in patients with intestinal BD.

Methods

We reviewed the medical records of all patients with intestinal BD who had undergone bowel resection surgery in a single tertiary academic medical center between 1991 and 2013. The cumulative probabilities of clinical recurrence were calculated using the Kaplan–Meier method, and predictive factors for recurrence were assessed by multivariate analysis.

Results

A total of 77 patients with intestinal BD received 5-ASA (n = 50, 64.9 %) or thiopurine (n = 27, 35.1 %) therapy after surgery at our center. The postoperative recurrence rate was lower in patients who received postoperative thiopurines (P = 0.050). The hazard ratio for recurrence was 0.636 (95 % confidence interval 0.130–1.016, P = 0.053) for postoperative thiopurine use compared with postoperative 5-ASA. However, the rates of re-operation, re-admission, and death were not significantly different between the 5-ASA and thiopurine groups.

Conclusions

Thiopurine therapy after surgery exhibited a modest effect in preventing recurrence in intestinal BD patients. More patients, long-term follow-up, and a randomized controlled design are necessary to validate the effectiveness of postoperative thiopurines in patients with this disease.

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Abbreviations

BD:

Behçet’s disease

IBD:

Inflammatory bowel disease

CD:

Crohn’s disease

Anti-TNF:

Antitumor necrosis factor

DAIBD:

Disease activity index for intestinal Behçet’s disease

HR:

Hazard ratio

CI:

Confidence interval

ECCO:

European Crohn’s and Colitis Organisation

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Acknowledgments

This research was supported by the grants of the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (Grant Numbers A111428, A120176, and HI13C1345), and it was supported by a faculty research grant of Yonsei University College of Medicine for 2012 (6-2012-0135).

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Authors and Affiliations

  1. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120–752, South Korea

    Hye Won Lee, Jae Hee Cheon, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Tae Il Kim & Won Ho Kim

  2. Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Hye Won Lee, Jae Hee Cheon, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Tae Il Kim & Won Ho Kim

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  1. Hye Won Lee
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Correspondence to Jae Hee Cheon.

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Lee, H.W., Cheon, J.H., Lee, H.J. et al. Postoperative Effects of Thiopurines in Patients with Intestinal Behçet’s Disease. Dig Dis Sci 60, 3721–3727 (2015). https://doi.org/10.1007/s10620-015-3799-1

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  • DOI: https://doi.org/10.1007/s10620-015-3799-1

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