Impact of thiopurines and anti-tumour necrosis factor therapy on hospitalisation and long-term surgical outcomes in ulcerative colitis  

作　　者：Christopher Alexakis Richard CG Pollok 

机构地区：[1]Department of Gastroenterology,St George's University and NHS Trust

出　　处：《World Journal of Gastrointestinal Surgery》2015年第12期360-369,共10页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Ulcerative colitis(UC) is a chronic inflammatory condition affecting the large bowel and is associated with a significant risk of both requirement for surgeryand the need for hospitalisation. Thiopurines, and more recently, anti-tumour necrosis factor(a TNF) therapy have been used successfully to induce clinical remission. However, there is less data available on whether these agents prevent long-term colectomy rates or the need for hospitalisation. The focus of this article is to review the recent and pertinent literature on the long-term impact of thiopurines and a TNF on long-term surgical and hospitalisation rates in UC. Data from population based longitudinal research indicates that thiopurine therapy probably has a protective role against colectomy, if used in appropriate patients for a sufficient duration. a TNF agents appear to have a short term protective effect against colectomy, but data is limited for longer periods. Whereas there is insufficient evidence that thiopurines affect hospitalisation, evidence favours that a TNF therapy probably reduces the risk of hospitalisation within the first year of use, but it is less clear on whether this effect continues beyond this period. More structured research needs to be conducted to answer these clinically important questions.Ulcerative colitis(UC) is a chronic inflammatory condition affecting the large bowel and is associated with a significant risk of both requirement for surgeryand the need for hospitalisation. Thiopurines, and more recently, anti-tumour necrosis factor(a TNF) therapy have been used successfully to induce clinical remission. However, there is less data available on whether these agents prevent long-term colectomy rates or the need for hospitalisation. The focus of this article is to review the recent and pertinent literature on the long-term impact of thiopurines and a TNF on long-term surgical and hospitalisation rates in UC. Data from population based longitudinal research indicates that thiopurine therapy probably has a protective role against colectomy, if used in appropriate patients for a sufficient duration. a TNF agents appear to have a short term protective effect against colectomy, but data is limited for longer periods. Whereas there is insufficient evidence that thiopurines affect hospitalisation, evidence favours that a TNF therapy probably reduces the risk of hospitalisation within the first year of use, but it is less clear on whether this effect continues beyond this period. More structured research needs to be conducted to answer these clinically important questions.

关 键 词：IMMUNOMODULATOR AZATHIOPRINE Antitumournecrosis factor THIOPURINE Ulcerative colitis HOSPITALISATION Surgery COLECTOMY Admission 

分 类 号：R657.1[医药卫生—外科学]