A search for the optimal duration of treatment with 6-mercaptopurine for ulcerative colitis.

Abstract

BACKGROUND AND AIMS:

6-mercaptopurine has proven to be effective in the treatment and maintenance of remission of ulcerative colitis (UC). The optimal duration of treatment with 6-MP is unknown. The intention of this study was to determine the best duration of treatment with 6-MP in terms of maintenance efficacy once remission has been achieved.

METHODS:

We reviewed the records from the inflammatory bowel disease (IBD) center at Lenox Hill Hospital and one large IBD practice in New York City of 334 patients treated with 6-MP for UC. These patients were followed from 4 months to 28.7 yr. Sixty-one patients were treated with 6-MP for at least 6 months and had at least a 3-month disease-free interval off steroids while on the medication. These patients were divided into two groups: Group 1 continued 6-MP and group 2 discontinued the drug at various times for reasons other than relapse. Time to relapse was calculated for both groups.

RESULTS:

A Kaplan-Meier survival analysis was employed and differences between the two groups were analyzed using the log-rank test. The median time to relapse in group 2 was 24 wk and in group 1 was 58 wk (p < 0.05). There were no significant differences between the two groups in age, gender, extent of disease, use of concomitant 5-ASA products, dose of 6-MP during remission, duration of UC, and duration of treatment with 6-MP before remission was achieved.

CONCLUSION:

Discontinuation of treatment with 6-MP while UC is in remission leads to a higher relapse rate than maintenance on 6-MP. Therefore, we favor the indefinite treatment with 6-MP in most patients.

• Authors: Efrat Z Lobel, Burton I Korelitz, Mark A Xuereb, Georgia Panagopoulos
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 99 Issue 3 Pg. 462-5 (Mar 2004) ISSN: 0002-9270 [Print] United States
• PMID: 15056086 (Publication Type: Journal Article)

Chemical References

• Immunosuppressive Agents
• Mercaptopurine

Topics

• Adult
• Aged
• Aged, 80 and over
• Colitis, Ulcerative (drug therapy)
• Female
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Mercaptopurine (therapeutic use)
• Middle Aged
• Recurrence
• Time Factors