Thiopurine naivety at tacrolimus induction is a predictor of long-term remission in patients with intractable ulcerative colitis who responded to tacrolimus
Noritaka Takatsu
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorTakashi Hisabe
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorMasahiro Kishi
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorTeruyuki Takeda
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorShigeyoshi Yasukawa
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorAkihiro Koga
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorKen Kinjo
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorCorresponding Author
Fumihito Hirai
Department of Gastroenterology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Correspondence
Fumihito Hirai, Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka City, Fukuoka 814-0180, Japan.
Email: [email protected]
Search for more papers by this authorToshiharu Ueki
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorKenshi Yao
Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorNoritaka Takatsu
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorTakashi Hisabe
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorMasahiro Kishi
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorTeruyuki Takeda
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorShigeyoshi Yasukawa
Inflammatory bowel disease center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorAkihiro Koga
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorKen Kinjo
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorCorresponding Author
Fumihito Hirai
Department of Gastroenterology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
Correspondence
Fumihito Hirai, Department of Gastroenterology, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka City, Fukuoka 814-0180, Japan.
Email: [email protected]
Search for more papers by this authorToshiharu Ueki
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorKenshi Yao
Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Search for more papers by this authorAbstract
Background
The short-term efficacy of tacrolimus (Tac) for steroid-dependent and steroid-resistant refractory ulcerative colitis (UC) has been demonstrated; however, its long-term outcomes have not been well documented. Thus, this study aimed to clarify the long-term outcomes of patients who achieved Tac-induced remission and identify its predictors.
Methods
This study included patients with moderate-to-severe active UC who started receiving Tac at our hospital between July 2004 and December 2016. Short-term treatment response was assessed using the Lichtiger index 3 months after starting Tac, and responding patients were further followed up to assess long-term outcomes. The primary endpoint was the relapse-free survival after Tac-induced remission, and the secondary endpoint was the identification of factors associated with relapse after Tac-induced remission.
Results
The cumulative relapse-free survival rate at 10 years after Tac-induced remission was 33.2%. Multivariate analysis revealed that being thiopurine naïve at Tac induction was associated with the absence of relapse (hazard ratio: 0.45; 95% confidence interval: 0.22–0.92).
Conclusions
Approximately one-third of patients who achieved Tac-induced remission maintained long-term remission. Being thiopurine naïve at Tac induction was a predictor of the absence of relapse.
Supporting Information
| Filename | Description |
|---|---|
| jgh16006-sup-0001-Table S1.docxWord 2007 document , 30.6 KB |
Table S1. A detailed schedule of medication regarding the entire cohort. UC-specific medication and the corresponding dose (daily dose [mg/day]) are shown for all patients at baseline and until 5 years for patients at risk. |
| jgh16006-sup-0002-Table S2.docxWord 2007 document , 28.6 KB |
Table S2. Duration of tacrolimus treatment stratified by thiopurine treatment status. |
| jgh16006-sup-0003-Table S3.docxWord 2007 document , 23.2 KB |
Table S3. Comparison of long-term prognosis between MES† 0 and 1. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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