The long-term outcome of ulcerative colitis treated with 6-mercaptopurine.
OBJECTIVE
To determine the long term outcome of ulcerative colitis in patients treated with 6-MP.


METHODS
The charts of 105 chronic refractory ulcerative colitis patients treated with 6-MP from 1973-1992 were reviewed. The focus was placed on clinical response, subsequent breakthrough while maintaining 6-MP, and relapse rates when 6-MP was discontinued.


RESULTS
Complete clinical remission was achieved in 68 patients (65%), partial remission was achieved in 25 patients (24%), and 12 patients (11%) failed to achieve remission. Of complete responders who continued 6-MP, 35% had a breakthrough, although complete remission was restored in 88% with the majority not requiring systemic steroids. Of complete responders who discontinued 6-MP, 87% subsequently relapsed. There were few major toxicities associated with 6-MP use.


CONCLUSIONS
6-MP is a reasonably safe and effective treatment for refractory ulcerative colitis. Patients who discontinue 6-MP after successful treatment have high relapse rates, therefore, 6-MP must be maintained long term to sustain remission.
George
J
J
Department of Medicine, Mount Sinai Medical Center, New York, New York, USA.
Present
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DH
Pou
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Bodian
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Rubin
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PH
D000328:Adult; D000636:Aminosalicylic Acids / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000963:Antimetabolites / Q000009:adverse effects / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D015122:Mercaptopurine / Q000009:adverse effects / Q000627:therapeutic use*; D019804:Mesalamine; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
D000636:Aminosalicylic Acids; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000963:Antimetabolites; D019804:Mesalamine; D015122:Mercaptopurine; D011241:Prednisone