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Thiopurines increased myeloid disorder risk among patients with IBD
Patients with inflammatory bowel disease who had past exposure to immunosuppressive thiopurines had increased risk for myeloid disorders, according to new research data.
Researchers conducted a prospective study of 19,486 patients (45% men; mean age, 38 years) with IBD (60% Crohn’s disease, 40% ulcerative colitis or unclassified IBD) enrolled in a French nationwide observational cohort from May 2004 to June 2005. They assessed incidence of myeloid disorders, including acute myeloid leukemia and myelodysplastic syndromes, among patients treated and not treated with thiopurines through a median follow-up of 35 months (interquartile range, 29-40 months). They also compared myeloid disorder incidence in the cohort with the general population using data from the French Network of Cancer Registries.
No increased risk for myeloid disorders was observed for the overall IBD population compared with the general population (standardized incidence ratio [SIR]=1.8; 95% CI, 0.58-4.2). Risk for myeloid disorders also was not increased in IBD patients with ongoing thiopurine treatment (SIR=1.54; 95% CI, 0.05-8.54) or in patients who never received thiopurine treatment (SIR=0.59; 95% CI, 0.02-3.28). However, IBD patients with past exposure to thiopurine had an increased risk for myeloid disorders (SIR=6.98; 95% CI, 1.44-20.36).
“Our results show that IBD patients who were receiving thiopurines at study inclusion and those who never received these drugs did not have an increased risk of [myeloid disorders],” the researchers concluded. “By contrast, past exposure to thiopurines increases the risk of [myeloid disorders] by sevenfold among IBD patients.”
Disclosure: See the study for a full list of relevant financial disclosures.