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Article Dans Une Revue Alimentary Pharmacology & Therapeutics (Suppl) Année : 2016

Excess risk of urinary tract cancers in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study

1 CHU Saint-Antoine [AP-HP]
2 LBM UMR 7203 - Laboratoire des biomolécules
3 DS3 - ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins
4 MSSM - Icahn School of Medicine at Mount Sinai [New York]
5 LNC - Lipides - Nutrition - Cancer (U866)
6 UPD5 - Université Paris Descartes - Paris 5
7 Service de Gastro-entérologie [CHU Cochin]
8 Hôpital Lariboisière
9 UPD7 - Université Paris Diderot - Paris 7
10 CIC Paris-Est - Centre d'investigation clinique Paris Est [CHU Pitié Salpêtrière]
11 UPMC - Université Pierre et Marie Curie - Paris 6
12 CRB HUEP-UPMC - Centre de Ressources Biologiques HUEP-UPMC
13 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
14 Service d'Hépato-gastro-entérologie [CHRU Nancy]
15 Hépatogastroentérologie
16 CIC Lille - Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301
17 Hépato-Gastroentérologie
18 University Hospital of Ioannina
19 Hôpital Saint-Louis
20 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
21 Gastroenterology
22 Service de Gastroentérologie et pancréatologie [CHU Toulouse]
23 INSERM - Institut National de la Santé et de la Recherche Médicale
24 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
25 Neuropathies du système nerveux entérique et pathologies digestives : implication des cellules gliales entériques
26 CHU Amiens-Picardie
27 Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne]
28 Clinic of Internal Medicine IV, Department of Gastroenterology and Hepathology
29 Service de Gastroentérologie [Hôpital Beaujon]
30 Hôpital Robert Debré
31 Service de gastroenterologie [CHU HEGP]
32 Université de Liège
33 CIC CHU ( Lille)/inserm
34 CHUV - Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne]
35 Institut National de Veille Sanitaire
36 Service d'Hépato-Gastro-Entérologie
Franck Carbonnel
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Gottfried Novacek
  • Fonction : Auteur
Silvio Danese
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Fabrizio Bossa
  • Fonction : Auteur
Mathurin Fumery
Philippe Seksik
Martti Färkkilä
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Baya Coulibaly
  • Fonction : Auteur
Olivier Dewit
  • Fonction : Auteur
Julie Demolin
  • Fonction : Auteur
Patricia Détré
  • Fonction : Auteur
Gaëlle Brillaut
  • Fonction : Auteur

Résumé

BackgroundThe risk of urinary tract cancers, including kidney and bladder cancers, was increased in transplant recipients receiving thiopurines.AimTo assess the risk of urinary tract cancers in patients with inflammatory bowel disease (IBD) receiving thiopurines in the CESAME observational cohort.MethodsBetween May 2004 and June 2005, 19 486 patients with IBD, 30.1% of whom were receiving thiopurines, were enrolled. Median follow‐up was 35 months (IQR: 29–40).ResultsTen and six patients developed respectively kidney and bladder cancer. The incidence rates of urinary tract cancer were 0.48/1000 patient‐years in patients receiving thiopurines (95% CI: 0.21–0.95), 0.10/1000 patient‐years in patients who discontinued thiopurines (95% CI: 0.00–0.56) and 0.30/1000 patient‐years in patients never treated with thiopurines (95% CI: 0.12–0.62) at entry. The standardised incidence ratio of urinary tract cancer was 3.40 (95% CI: 1.47–6.71, P = 0.006) in patients receiving thiopurines, 0.64 (95% CI: 0.01–3.56, P = 0.92) in patients previously exposed to thiopurines and 1.17 (95% CI: 0.47–12.42, P = 0.78) in patients never treated with thiopurines. The multivariate‐adjusted hazard ratio (HR) of urinary tract cancer between patients receiving thiopurines and those not receiving thiopurines was 2.82 (95% CI: 1.04–7.68, P = 0.04). Other significant risk factors were male gender (HR: 3.98, 95% CI: 1.12–14.10, P = 0.03) and increasing age (HR after 65 years (ref <50): 13.26, 95% CI: 3.52–50.03, P = 0.0001).ConclusionPatients with IBD receiving thiopurines have an increased risk of urinary tract cancers. Clinically relevant excess risk is observed in older men.

Dates et versions

hal-02013807 , version 1 (11-02-2019)

Identifiants

Citer

A. Bourrier, F. Carrat, F. Colombel, A. Bouvier, Vered Abitbol, et al.. Excess risk of urinary tract cancers in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Alimentary Pharmacology & Therapeutics (Suppl), 2016, 43 (2), pp.252-261. ⟨10.1111/apt.13466⟩. ⟨hal-02013807⟩
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