Discover and read the best of Twitter Threads about #thiopurines
Most recents (3)
@MondayNightIBD 2/📣#IBD & meds carry an⬆️risk of #Malignancies, including lymphomas
🔺Who is at risk?
🔺Is it IBD-mediated or drug-related?
🔺What is our prevention & screening🔎strategy?
Thank you for joining this special #MondayNightIBD #Back2Basics @DuekerJeffrey
🔺Who is at risk?
🔺Is it IBD-mediated or drug-related?
🔺What is our prevention & screening🔎strategy?
Thank you for joining this special #MondayNightIBD #Back2Basics @DuekerJeffrey
@MondayNightIBD @DuekerJeffrey @amelia_kellar @DCharabaty @IBD_Afzali @drdani23 @ibddoctor @EdithHoMD @fgomollon @IBD_DrEMF @ibdgijami @MaiaKayalMD 3/ 🔥IBD may carry a unique risk of primary intestinal lymphoma (PILD), but NO🔼risk of extra-intestinal NHL
In CESAME population,
▪️Crude IR of PILD was 0.12/1000 patient-years (py)
▪️All B-cell NH LD
▪️79% ♂️, 11 CD, 3 UC
▪️86% arose in IBD lesions
▪️45% were EBV positive
In CESAME population,
▪️Crude IR of PILD was 0.12/1000 patient-years (py)
▪️All B-cell NH LD
▪️79% ♂️, 11 CD, 3 UC
▪️86% arose in IBD lesions
▪️45% were EBV positive
@MondayNightIBD @DuekerJeffrey @amelia_kellar @DCharabaty @IBD_Afzali @drdani23 @ibddoctor @EdithHoMD @fgomollon @IBD_DrEMF @ibdgijami @MaiaKayalMD @JChristieMD @KDeFelice_IBD @dunleavy_katie @IBDMD @MN_GIMD @SaraElOualiMD @nloganmd @KrugCleveland @PDulaiMD @PriSantiagoMD 4/ Lymphoma in #IBD is mostly linked to IBD therapy, particularly #Thiopurines (6MP, AZA)
🔺⬆️Risk in CD, less evidence with UC
🔺M>F
🔺Risk increases with exposure⏲️, particularly >2 years
🔺Risk decrease after cessation of AZA
🔺⬆️Risk in CD, less evidence with UC
🔺M>F
🔺Risk increases with exposure⏲️, particularly >2 years
🔺Risk decrease after cessation of AZA
@MondayNightIBD @DCharabaty 1/ Thiopurines are associated with an increased risk of NMSC (non-melanoma skin cancer)
Which of the following is true about this risk relative to non-exposed IBD pts, duration of thiopurine use , and after thiopurine cessation 🛑#Back2Basics #MondayNightIBD
Which of the following is true about this risk relative to non-exposed IBD pts, duration of thiopurine use , and after thiopurine cessation 🛑#Back2Basics #MondayNightIBD
@MondayNightIBD @DCharabaty 32 y/o M with UC here for f/u. In remission x7 yrs on AZA 75mg/d. He is here to discuss his concerns about his risk of lymphoma associated w/ AZA. (HSTCL= hepatosplenic T cell; EBV-L= EBV assoc lymphoma) Which statement is true?
#Back2Basics #MondayNightIBD
#Back2Basics #MondayNightIBD
@MondayNightIBD @DCharabaty 2/ ‼️Cancer risk in IBD‼️can be→
🔺Disease related (eg CRC, anal CA)
🔺Therapy related ( Skin, Lymphoma, Cervical, Anal)
🔺Disease related (eg CRC, anal CA)
🔺Therapy related ( Skin, Lymphoma, Cervical, Anal)
@MondayNightIBD @SobiaMujtabaMD @JasonHouMD @DCharabaty 1/ 65 y/o M new dx #Crohns ileitis after he presented w abdo pain,diarrhea, wt loss, anemia. CLN: deep linear ulcers in TI. He has an active lifestyle,stable CAD. Symptoms recur when prednisone<15 mg. What is the LEAST effective strategy to keep this pt in remission? #Back2Basics
@MondayNightIBD @SobiaMujtabaMD @JasonHouMD @DCharabaty 2/ #IBD is not only a disease of the young !
♦️ Typical dx age 20-39, w a second smaller peak >50
♦️ Recently ⬆️ prevalence in elderly> age 60, due to:
🔺Aging of adults w #IBD
🔺⬆️elderly onset IBD > age 60 #EOIBD:
🔹⬆️awareness & dx
🔹Environment/ microbiome changes
♦️ Typical dx age 20-39, w a second smaller peak >50
♦️ Recently ⬆️ prevalence in elderly> age 60, due to:
🔺Aging of adults w #IBD
🔺⬆️elderly onset IBD > age 60 #EOIBD:
🔹⬆️awareness & dx
🔹Environment/ microbiome changes
@MondayNightIBD @SobiaMujtabaMD @JasonHouMD @DCharabaty 3/ Clinical Features of #IBD in #elderly 🔎?
📌Milder disease course, Fewer #Crohns complications, but
⬆️rates of hospitalizations
⬆️rates of colectomy in EO UC
📌❓Due to disease severity vs poor #IBD control d/t underuse of effective Rx
📌Milder disease course, Fewer #Crohns complications, but
⬆️rates of hospitalizations
⬆️rates of colectomy in EO UC
📌❓Due to disease severity vs poor #IBD control d/t underuse of effective Rx
