P780 Prognosis and optimal treatment for 5-aminosalicylic acid-intolerant patients with Ulcerative Colitis

Abstract Background 5-aminosalicylic acid (5-ASA) is widely used as a first-line treatment for ulcerative colitis (UC), but intolerance sometimes occurs. 5-ASA-intolerance was considered risk factor colectomy in UC patients, no reports have examined which suitable to avoid 5-ASA-intolerant patients. This the first report describing strategy UC. The aims of this study were determine optimal therapeutic Methods retrospective cohort involved patients who newly diagnosed having after January 2010 and received oral 5-ASA agents. Patients when they fulfilled two or more following conditions: (1) paradoxical aggravation on introducing agents allergic reactions agents; (2) obvious improvement abdominal symptoms discontinuation (3) positive drug-induced lymphocyte stimulation test (DLST) at least formulations 5-ASA; (4) adverse events re-challenge with (5) severe owing Results Of 950 history administration, 213 (22.4%) 5-ASA-intolerant. Five-year colectomy-free survival significantly lower compared 5-ASA-tolerant (73% vs. 84%, respectively). From multivariate Cox proportional hazards model analysis patient cohort, thiopurine use shown contribute avoidance (hazard ratio = 0.25; 95% confidence interval, 0.13–0.47; P < 0.001); however, also likely be thiopurine-intolerant (27% 15%, respectively; 0.04). Calcineurin inhibitor associated an increased 4.80; 2.24–10.3; 0.001), while systemic corticosteroids biologics did not affect rate 1.07; 0.60–1.91; 0.81). Conclusion Treatment thiopurines demonstrated potential improve prognosis However, it should noted that frequent Compared biologics, calcineurin inhibitors may colectomy, preferred intractable intolerance. UC, we believe will many implications clinical practice.