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Safety of thiopurine + allopurinol vs thiopurine monotherapy

ECCO 2019

IBD patients on thiopurine and allopurinol did not have a statistically significant different risk of adverse outcomes (including initiation of a biologic) when compared with IBD patients exposed to thiopurine monotherapy. This conclusion is based on an analysis of a nationwide cohort of Danish IBD patients who had been prescribed thiopurine therapy between 1999 and 2014 [1].

In this period, 10,367 patients with IBD (5,484 Crohn’s disease and 4,883 ulcerative colitis) were prescribed thiopurines; 217 of them used allopurinol co-therapy. The primary outcome was a composite of any adverse outcome or need for biological treatment: IBD-related hospitalisation, IBD-related surgery, biological therapy initiation, or death. In patients exposed to allopurinol co-therapy, there were 40 incident outcomes in 129 person-years (PY) (incidence rate 310.1 per 1,000 PY). In patients exposed to thiopurine monotherapy, 4,745 outcomes among 24,585 PY were observed (incidence...

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