The risk of non‐melanoma skin cancer in New Zealand in inflammatory bowel disease patients treated with thiopurines

Bahi, Morwan; Walmsley, Russell; Gray, Andrew; Young, David; Hobbs, Catherine; Aluzaite, Kristina; Schultz, Michael

doi:10.1111/jgh.14041

Cited by 9 publications

(8 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the past few years, to Big Data has become one of the most‐used vocabulary in the industrial sector, finance, and healthcare 2,3 . Most areas have begun to use big data to analyze and discover new value 4,5 . The information brought by big data is also changing the ecosystem of medical education and medicine.…”

Section: Introductionmentioning

confidence: 99%

Brief introduction of medical database and data mining technology in big data era

Yang

Liu

et al. 2020

J Evidence Based Medicine

428

285

View full text Add to dashboard Cite

Data mining technology can search for potentially valuable knowledge from a large amount of data, mainly divided into data preparation and data mining, and expression and analysis of results. It is a mature information processing technology and applies database technology. Database technology is a software science that researches manages, and applies databases. The data in the database are processed and analyzed by studying the underlying theory and implementation methods of the structure, storage, design, management, and application of the database. We have introduced several databases and data mining techniques to help a wide range of clinical researchers better understand and apply database technology.

show abstract

Section: Introductionmentioning

confidence: 99%

Brief introduction of medical database and data mining technology in big data era

Yang

Liu

et al. 2020

J Evidence Based Medicine

428

285

View full text Add to dashboard Cite

show abstract

“…Our finding that thiopurine use but also the cumulative thiopurine dose did not associate with KSC development may be surprising as they are not in line with current guidelines that strictly advise yearly dermatologically screening of thiopurine-treated IBD patients, however, the literature is divided on the effect of thiopurine use on KSC development itself (see also supplementary Table 1, Supplemental digital content 1, http://links.lww.com/EJGH/A902) [7,14,19–22,24–28,30,35,36]. Several studies show results similar to ours and do not show an association between KSC diagnoses and thiopurine use in patients with IBD [11,31,37–41].…”

Section: Discussionmentioning

confidence: 88%

“…Most international guidelines recommend yearly dermatologically screening of thiopurine-treated patients [19,20,[23][24][25]27,28]. However, this is not always feasible in most countries due to the limited capacity of the health care system, the large and increasing volume of patients with KSC, and the increasing prevalence of IBD [29].…”

Section: Introductionmentioning

confidence: 99%

“…It is unknown if cumulative dose of thiopurine exposure adds to the increased KSC risk in IBD patients [2,9,14,18,[22][23][24]26]. Studies investigating this question are limited by specific patient populations or the low number of patients [14,[19][20][21]26,28,30]. In this case-control study we aimed to investigate the dose-response relation of thiopurine exposure, specified as cumulative dose and duration of use, on the development of KSC in patients with IBD.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cumulative thiopurine dosing and keratinocyte skin cancer in inflammatory bowel disease: a case-control study

Jansen,

den Broeder,

Lubeek

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

Background and aim Patients with inflammatory bowel disease (IBD) treated with thiopurines are at increased risk of keratinocyte skin cancer (KSC). Most international guidelines recommend yearly dermatological screening of thiopurine-treated patients. Whether the association between the development of KSC and the use of thiopurines is dose-dependent remains unclear. The aim of this study was to investigate the association between the cumulative thiopurine dose and KSC development in patients with IBD which can be helpful to assist in further skin cancer risk stratification and personalization of screening recommendations in patients with IBD. Methods We performed a single-center case-control study, including patients with IBD with and without a history of KSC (cases and controls, respectively). The primary outcome was the association of cumulative azathioprine, mercaptopurine and thioguanine dose with KSC development. Univariable and multivariable logistic regression analyses were performed, the latter corrected for age and smoking, known risk factors of KSC. Results We included 50 cases and 150 controls, predominantly white population. Age and current azathioprine use were univariably significantly associated with KSC development. In multivariable logistic regression analyses, age at inclusion remained significantly associated. Cumulative doses of thiopurines (separate or combined) or duration of thiopurine use did not impact KSC risk, also after correcting for age and smoking. Conclusion Cumulative thiopurine dose and duration did not show an association with KSC development. Future KSC risk stratification, based on all available KSC risk factors, may aid in selecting individuals who can benefit most from dermatologic screening programs.

show abstract

“…In fact, a recent cohort study (in which patients 65 years and older represented 12% of the study population) by Lemaitre et al[40] found that risk of lymphoma was higher in patients treated with thiopurine monotherapy (mean exposure time was 17 mo) and those treated with combination therapy (thiopurine and anti-TNF, mean exposure time was 8 mo) in comparison to those patients unexposed to such treatments. In addition, in their retrospective observational study, Bahi et al[41] showed a potentially multiplicative risk of non-melanoma skin cancer with increasing age in thiopurine-exposed IBD patients (6 months or longer exposure, median exposure of 42 months). In contrast, a recent cohort study by Cheddani et al[42] of elderly-onset IBD found that thiopurine exposure was not associated with an increased risk of developing cancer when using a time-dependant Cox model.…”

Section: Medical Therapymentioning

confidence: 99%

Elderly patients with inflammatory bowel disease: Updated review of the therapeutic landscape

LeBlanc

Wiseman

Lakatos

et al. 2019

WJG

View full text Add to dashboard Cite

High-quality data remains scarce in terms of optimal management strategies in the elderly inflammatory bowel disease (IBD) population. Indeed, available trials have been mostly retrospective, of small sample size, likely owing to under-representation of such a population in the major randomized controlled trials. However, in the last five years, there has been a steady increase in the number of published trials, helping clarify the estimated benefits and toxicity of the existing IBD armamentarium. In the Everhov trial, prescription strategies were recorded over an average follow-up of 4.2 years. A minority of elderly IBD patients (1%-3%) were treated with biologics within the five years following diagnosis, whilst almost a quarter of these patients were receiving corticosteroid therapy at year five of follow-up, despite its multiple toxicities. The low use of biologic agents in real-life settings likely stems from limited data suggesting lower efficacy and higher toxicity. This minireview will aim to highlight current outcome measurements as it portends the elderly IBD patient, as well as summarize the available therapeutic strategies in view of a growing body of evidence.

show abstract

The risk of non‐melanoma skin cancer in New Zealand in inflammatory bowel disease patients treated with thiopurines

Abstract: We found a twofold to threefold increase in NMSC incidence in IBD patients treated with thiopurines in NZ, despite the high background incidence rate.

Cited by 9 publications

References 34 publications

Brief introduction of medical database and data mining technology in big data era

Brief introduction of medical database and data mining technology in big data era

Cumulative thiopurine dosing and keratinocyte skin cancer in inflammatory bowel disease: a case-control study

Elderly patients with inflammatory bowel disease: Updated review of the therapeutic landscape

Contact Info

Product

Resources

About