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https://hdl.handle.net/2440/103788
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dc.contributor.author | De Cruz, P. | - |
dc.contributor.author | Kamm, M.A. | - |
dc.contributor.author | Hamilton, A.L. | - |
dc.contributor.author | Ritchie, K.J. | - |
dc.contributor.author | Krejany, E.O. | - |
dc.contributor.author | Gorelik, A. | - |
dc.contributor.author | Liew, D. | - |
dc.contributor.author | Prideaux, L. | - |
dc.contributor.author | Lawrance, I.C. | - |
dc.contributor.author | Andrews, J.M. | - |
dc.contributor.author | Bampton, P.A. | - |
dc.contributor.author | Jakobovits, S. | - |
dc.contributor.author | Florin, T.H. | - |
dc.contributor.author | Gibson, P.R. | - |
dc.contributor.author | Debinski, H. | - |
dc.contributor.author | Gearry, R.B. | - |
dc.contributor.author | Macrae, F.A. | - |
dc.contributor.author | Leong, R.W. | - |
dc.contributor.author | Kronborg, I. | - |
dc.contributor.author | Radford-Smith, G. | - |
dc.contributor.author | et al. | - |
dc.date.issued | 2015 | - |
dc.identifier.citation | Alimentary Pharmacology and Therapeutics, 2015; 42(7):867-879 | - |
dc.identifier.issn | 0269-2813 | - |
dc.identifier.issn | 1365-2036 | - |
dc.identifier.uri | http://hdl.handle.net/2440/103788 | - |
dc.description.abstract | Background: Crohn's disease recurs in the majority of patients after intestinal resection. Aim: To compare the relative efficacy of thiopurines and anti-TNF therapy in patients at high risk of disease recurrence. Methods: As part of a larger study comparing post-operative management strategies, patients at high risk of recurrence (smoker, perforating disease, ≥2nd operation) were treated after resection of all macroscopic disease with 3 months metronidazole together with either azathioprine 2 mg/kg/day or mercaptopurine 1.5 mg/kg/day. Thiopurine-intolerant patients received adalimumab induction then 40 mg fortnightly. Patients underwent colonoscopy at 6 months with endoscopic recurrence assessed blind to treatment. Results: A total of 101 patients [50% male; median (IQR) age 36 (25–46) years] were included. There were no differences in disease history between thiopurine- and adalimumab-treated patients. Fifteen patients withdrew prior to 6 months, five due to symptom recurrence (of whom four were colonoscoped). Endoscopic recurrence (Rutgeerts score i2–i4) occurred in 33 of 73 (45%) thiopurine vs. 6 of 28 (21%) adalimumab-treated patients [intention-to-treat (ITT); P = 0.028] or 24 of 62 (39%) vs. 3 of 24 (13%) respectively [per-protocol analysis (PPA); P = 0.020]. Complete mucosal endoscopic normality (Rutgeerts i0) occurred in 17/73 (23%) vs. 15/28 (54%) (ITT; P = 0.003) and in 27% vs. 63% (PPA; P = 0.002). The most advanced disease (Rutgeerts i3 and i4) occurred in 8% vs. 4% (thiopurine vs. adalimumab). Conclusions: In Crohn's disease patients at high risk of post-operative recurrence adalimumab is superior to thiopurines in preventing early disease recurrence. | - |
dc.description.statementofresponsibility | P. De Cruz ... J. M. Andrews ... et al. | - |
dc.language.iso | en | - |
dc.publisher | Wiley | - |
dc.rights | © 2015 John Wiley & Sons Ltd | - |
dc.source.uri | http://dx.doi.org/10.1111/apt.13353 | - |
dc.subject | Humans | - |
dc.subject | Crohn Disease | - |
dc.subject | Recurrence | - |
dc.subject | Metronidazole | - |
dc.subject | Azathioprine | - |
dc.subject | Tumor Necrosis Factor-alpha | - |
dc.subject | Colonoscopy | - |
dc.subject | Treatment Outcome | - |
dc.subject | Drug Therapy, Combination | - |
dc.subject | Postoperative Period | - |
dc.subject | Risk Factors | - |
dc.subject | Follow-Up Studies | - |
dc.subject | Adult | - |
dc.subject | Aged | - |
dc.subject | Middle Aged | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.subject | Adalimumab | - |
dc.subject | Mercaptopurine | - |
dc.title | Efficacy of thiopurines and adalimumab in preventing Crohn's disease recurrence in high-risk patients - a POCER study analysis | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1111/apt.13353 | - |
dc.relation.grant | NHMRC | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Liew, D. [0000-0002-0131-623X] | - |
dc.identifier.orcid | Andrews, J.M. [0000-0001-7960-2650] | - |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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