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

Summary Background The risk of urinary tract cancers, including kidney and bladder cancers, was increased in transplant recipients receiving thiopurines. Aim To assess the risk of urinary tract cancers in patients with inflammatory bowel disease (IBD) receiving thiopurines in the CESAME observationa...

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Published in:Alimentary Pharmacology & Therapeutics (Suppl) 2016-01, Vol.43 (2), p.252-261
Main Authors: Beaugerie, L., Lémann, Marc, Cadiot, Guillaume, Duclos, Bernard, Bonaz, Bruno, Nion‐Larmurier, Isabelle, Delchier, Jean‐Charles, Chaussade, Stanislas, Coffin, Benoit, Delasalle, Patrick, Souffran, Marc‐Henry, Gouilloud, Sylvie, Savoye, Guillaume, Brazier, Franck, Bensaude, Raoul‐Jacques, Nisard, Andrée, Capelle, Philippe, Dabadie, Alain, Goldfain, Denis, Lemière, Sébastien, Nalet, Bernard, Roux, Jean‐Pol, Reville, Marc, Hugot, Jean‐Pierre, Lescut, Dominique, Ouvry, Dominique, Wittersheim, Christian, Attar, Alain, Guemene, Jean‐Marc, Claude, Pierre, Chatrenet, Philippe, Dubois, Philippe, Pereira, Adelino, Ngo, Yann, Gotlib, Jean Pierre, Raoux, Philippe, Chapoutot, Christian, Mudry, Jean, Bolze, Jean‐Louis, Meurisse, Jean‐Jacques, Bellaiche, Guy, Desurmont, Philippe, Decroix, Bruno, Dib, Nina, Lagier, Emmanuel, Fallourd, Philippe, Delon, Bernard, Arotçarena, Ramuntxo, Broyer, Joel, Godeberge, Béatrice, Puech, Jean, Pornin, Béatrice, Champigneulle, Bruno, David, Xavier‐Richard, Lombard, Frédéric, Hamon, Jean‐François, Vidal, Alain, Coupier, Dominique, Auroux, Jean, Lentini, Franck, Leveque, Anne‐Marie, Tusseau, Frank, Vincent, Edmond, Vitte, René‐Louis, Carwana, Alain, Helbert, Thierry, Barré, Philippe, Jacques, Christian, Kezachian, Gilles, Bismuth, Michaël, Delanoe, Christophe, De Montigny, Stéphanie, Soudan, Denis, Dadamessi, Innocenti, Lenaerts, Catherine, Garret, Marc, Fayemendy, Laurent, Michaudel, Gilles, Missonnier, Gilles, Bourbon, Pierre, Gros, Pascal, Glibert, André, Bineau, Catherine, Hartwig, Johannes, Pelatan, Cécile, Doubremelle, Marie, Roche, Hervé, Chryssostalis, Ariane, Khaddari, Saïd, Gury, Bruno, Wantiez, Michel, Durous, Eric, Gazut, Valérie, Plane, Alain, Croguennec, Bernard, Gelsi, Eve, Ponsot, Philippe, Maroy, Bernard, Dall'Osto, Hélène, De Lustrac, Mercédes
Format: Article
Language:English
Subjects:
Adult
Bacteriology
Biochemistry, Molecular Biology
Cancer
Cohort analysis
Cohort Studies
Female
Health risk assessment
Health risks
Humans
Incidence
Inflammatory bowel disease
Inflammatory bowel diseases
Inflammatory Bowel Diseases - drug therapy
Intestine
Kidneys
Life Sciences
Male
Microbiology and Parasitology
Middle Aged
Molecular biology
Observational studies
Patients
Proportional Hazards Models
Prospective Studies
Risk Factors
Urinary tract
Urogenital system
Urologic Neoplasms - epidemiology
Urologic Neoplasms - etiology
Young Adult
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Summary:Summary Background The risk of urinary tract cancers, including kidney and bladder cancers, was increased in transplant recipients receiving thiopurines. Aim To assess the risk of urinary tract cancers in patients with inflammatory bowel disease (IBD) receiving thiopurines in the CESAME observational cohort. Methods Between 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). Results Ten 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
ISSN:0269-2813
0953-0673
1365-2036
DOI:10.1111/apt.13466