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Use of thiopurines associated with skin cancer in UC patients
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SAN DIEGO — Ulcerative colitis patients were twice as likely to develop nonmelanoma skin cancer while receiving thiopurines compared with unexposed patients, a speaker said here.
“The risk of nonmelanoma skin cancer increased gradually for successive years of [thiopurine] therapy,” Ali Abbas MD, MPH, of the department of internal medicine, University of Florida, said at the American College of Gastroenterology Annual Scientific Meeting. However, “the risk of nonmelanoma skin cancer [NMSC] returned to pre-exposure levels after discontinuation.”
Researched performed a retrospective cohort study based on data from 2001 to 2011 from the Veterans Affairs health care system, following patients from ulcerative colitis diagnosis to the end of the study period or development of NMSC, Abbas said. Regression analysis was used to control for demographics, ultraviolet radiation exposure and frequency of visits to the VA facility to control detection bias.
Researchers examined 14,527 patients with a median follow-up of 8.1 years. Twenty-three percent of patients (n=3,346) used thiopurines for a median of 1.6 years, and 421 NMSC cases were identified.
The adjusted HRs for patients developing NMSC were 2.1 (95% CI, 1.6-2.6) while on thiopurine and 0.7 (95% CI, 0.5-1) after stopping therapy, although the reduced risk after discontinuation was not significant.
Among patients who never used thiopurines, the NMSC rate was 3.7 per 1,000 person-years, Abbas said. For those who used thiopurines, the rate rose from 5.8 per 1,000 person-years in the first year of exposure to 7.9 in the second year, 8.3 in the third, 7.8 in the fourth and 13.6 in the fifth year. After 5 years, the rate was 10.7 per 1,000 person-years.
“It’s crucial to educate physicians and patients about the risk of nonmelanoma skin cancer and possible preventive measures,” Abbas said.
Disclosure: The researchers report no relevant financial disclosures.
For more information:
Abbas A. #69: Risk of Nonmelanoma Skin Cancer in Ulcerative Colitis Patients Treated with Thiopurines: A Nationwide Retrospective Cohort. Presented at: the 2013 American College of Gastroenterology Annual Scientific Meeting; Oct. 11-16, San Diego.