Mo1901 Long-Term Efficacy and Safety of Thiopurines in Patients With Biologic-Naïve Ulcerative Colitis: A Multicenter Cohort Study

Objectives:To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.Design:Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.Setting:Services of infectious diseases and oncology of 12 university hospitals in Paris, France.Participants:In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.Results:Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.Conclusions:Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

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Mo1886 Mid- to Long-Term Stability and Associated Prognostic Factors of Adalimumab Treatment for 1189 Patients With Crohn's Disease: A Multicenter Cohort Study

Gastroenterology ◽

10.1016/s0016-5085(16)32728-7 ◽

2016 ◽

Vol 150 (4) ◽

pp. S806

Author(s):

Hiroki Tanaka ◽

Noriko Kamata ◽

Akihiro Yamada ◽

Katsuya Endo ◽

Toshimitsu Fujii ◽

...

Keyword(s):

Cohort Study ◽

Crohn’S Disease ◽

Prognostic Factors ◽

Crohn's Disease ◽

Multicenter Cohort Study ◽

Term Stability ◽

Long Term Stability ◽

Multicenter Cohort ◽

Adalimumab Treatment

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P461 Intolerance to 5-aminosalicylate is a risk of poor prognosis in ulcerative colitis patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.590 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S409-S410

Author(s):

T Fujii ◽

S Hibiya ◽

C Maeyashiki ◽

E Saito ◽

K Takenaka ◽

...

Keyword(s):

Ulcerative Colitis ◽

Cohort Study ◽

Confidence Interval ◽

Maintenance Therapy ◽

Retrospective Review ◽

Poor Prognosis ◽

Hazard Ratio ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Significant Difference

Abstract Background 5-Aminosalicylates (5-ASA) are the key drugs in induction and maintenance therapy in ulcerative colitis (UC). Some UC patients are involved in 5-ASA intolerance after induction of oral 5-ASA compounds. There is no evidence of the prognosis including the risk of colectomy in 5-ASA intolerant UC patients. Methods The aim of this study is to establish the prognosis of 5-ASA intolerant UC patients in a multicenter cohort study. A retrospective review of a prospective multicenter database (2014–2018) of 1,574 UC patients was carried out and a total of 1,286 patients treated with oral 5-ASA compounds were enrolled. We compared the risk of colectomy and biologics induction between patients (i) tolerant to first 5-ASA compound (1079), (ii) intolerant to first 5-ASA compound but tolerant to other 5-ASA compound (107) and (iii) intolerant to 5-ASA compound and withdrawal of 5-ASA (100). Results We identified 1,286 patients with UC, of which 40 patients (3.1%) resulted in colectomy and 247 patients (19%) treated with biologics. Colectomy rate in patients (iii) intolerant to 5-ASA and withdrawal of 5-ASA were higher than (i) tolerant to first 5-ASA and (ii) intolerant to first 5-ASA but tolerant to other 5-ASA (9.0%, 2.7%, 1.9%, respectively). (iii) Patients withdrawal of 5-ASA showed higher risk of colectomy compared with (i) tolerant to first 5-ASA (Hazard ratio (HR) 4.71, 95% Confidence interval (CI): 2.04–10.8). The risk of colectomy among (ii) patients intolerant to first 5-ASA but tolerant to other 5-ASA showed no significant difference compared with (i) tolerant to first 5-ASA (HR 0.76, 95% CI: 0.43–1.35). The biologics induction rate in (iii) patients withdrawal of 5-ASA was significantly higher than (i) tolerant to first 5-ASA and (ii) intolerant to first 5-ASA but tolerant to other 5-ASA (37%, 18%, 16%, respectively). Also (iii) patients withdrawal of 5-ASA showed higher risk of induction with biologics compared with (i) tolerant to first 5-ASA (HR 2.35, 95% CI: 1.50–3.68). Those risk among (ii) patients intolerant to first 5-ASA but tolerant to other 5-ASA showed no significant difference compared with (i) tolerant to first 5-ASA (HR 0.76, 95% CI: 0.43–1.35). Conclusion Patients with UC who had 5-ASA intolerance and withdrew from 5-ASA showed poor prognosis. We should consider trying other 5-ASA compounds even if the patients had intolerance to one 5-ASA compound.

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