Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.

<h4>Objective</h4>Inflammatory bowel disease (IBD) is commonly treated with thiopurines such as azathioprine and mercaptopurine for the maintenance of remission. Studies examining chemopreventive of these medications on colorectal neoplasm in IBD patients have yielded conflicting results...

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Autores principales:	Jianfeng Gong, Lijing Zhu, Zhen Guo, Yi Li, Weiming Zhu, Ning Li, Jieshou Li
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/df9b2eb1f85e470188f06a04de9ed493
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spelling	oai:doaj.org-article:df9b2eb1f85e470188f06a04de9ed4932021-11-18T08:44:16ZUse of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.1932-620310.1371/journal.pone.0081487https://doaj.org/article/df9b2eb1f85e470188f06a04de9ed4932013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24312308/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Inflammatory bowel disease (IBD) is commonly treated with thiopurines such as azathioprine and mercaptopurine for the maintenance of remission. Studies examining chemopreventive of these medications on colorectal neoplasm in IBD patients have yielded conflicting results. We performed a meta-analysis to assess the role of thiopurines for this indication.<h4>Methods</h4>We performed a systematic search of PubMed, Web of Science, EMBASE and Cochrane to identify studies reporting colorectal neoplasm from IBD patients treated with thiopurines and conducted a meta-analysis of pooled relative risk (RR) using the random effects model.<h4>Results</h4>Nine case-control and ten cohort studies fulfilled the inclusion criteria. The use of thiopurines was associated with a statistically significant decreased incidence of colorectal neoplasm (summary RR=0.71, 95% CI=0.54-0.94, p=0.017), even after adjustment for duration and extent of the disease, but there was high heterogeneity among studies (I(2)=68.0%, p<0.001). The RR of advanced neoplasm (high-grade dysplasia and cancer) was 0.72 (95%CI=0.50-1.03, p=0.070) and that of cancer was 0.70 (95% CI=0.46-1.09, p=0.111) for thiopurine-treated patients. Heterogeneity of the studies was affected by the sample size (</≥ 100 cases) and whether the patients had longstanding colitis (≥ 7 years).<h4>Conclusion</h4>The current meta-analysis revealed that thiopurines had a chemopreventive effect of colorectal neoplasms and a tendency of reducing advanced colorectal neoplasms in IBD. Due to the heterogeneity of included studies, these results should be interpreted with caution.Jianfeng GongLijing ZhuZhen GuoYi LiWeiming ZhuNing LiJieshou LiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e81487 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jianfeng Gong Lijing Zhu Zhen Guo Yi Li Weiming Zhu Ning Li Jieshou Li Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.
description	<h4>Objective</h4>Inflammatory bowel disease (IBD) is commonly treated with thiopurines such as azathioprine and mercaptopurine for the maintenance of remission. Studies examining chemopreventive of these medications on colorectal neoplasm in IBD patients have yielded conflicting results. We performed a meta-analysis to assess the role of thiopurines for this indication.<h4>Methods</h4>We performed a systematic search of PubMed, Web of Science, EMBASE and Cochrane to identify studies reporting colorectal neoplasm from IBD patients treated with thiopurines and conducted a meta-analysis of pooled relative risk (RR) using the random effects model.<h4>Results</h4>Nine case-control and ten cohort studies fulfilled the inclusion criteria. The use of thiopurines was associated with a statistically significant decreased incidence of colorectal neoplasm (summary RR=0.71, 95% CI=0.54-0.94, p=0.017), even after adjustment for duration and extent of the disease, but there was high heterogeneity among studies (I(2)=68.0%, p<0.001). The RR of advanced neoplasm (high-grade dysplasia and cancer) was 0.72 (95%CI=0.50-1.03, p=0.070) and that of cancer was 0.70 (95% CI=0.46-1.09, p=0.111) for thiopurine-treated patients. Heterogeneity of the studies was affected by the sample size (</≥ 100 cases) and whether the patients had longstanding colitis (≥ 7 years).<h4>Conclusion</h4>The current meta-analysis revealed that thiopurines had a chemopreventive effect of colorectal neoplasms and a tendency of reducing advanced colorectal neoplasms in IBD. Due to the heterogeneity of included studies, these results should be interpreted with caution.
format	article
author	Jianfeng Gong Lijing Zhu Zhen Guo Yi Li Weiming Zhu Ning Li Jieshou Li
author_facet	Jianfeng Gong Lijing Zhu Zhen Guo Yi Li Weiming Zhu Ning Li Jieshou Li
author_sort	Jianfeng Gong
title	Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.
title_short	Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.
title_full	Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.
title_fullStr	Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.
title_full_unstemmed	Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.
title_sort	use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/df9b2eb1f85e470188f06a04de9ed493
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Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.

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