Original ResearchFull Report: Clinical—Alimentary TractRisk of Lymphoma in Patients With Ulcerative Colitis Treated With Thiopurines: A Nationwide Retrospective Cohort Study
Section snippets
Study Population
Nationwide data were obtained from the VA Pharmacy Benefits Management and Corporate Data Warehouse databases. Veterans who were seen and followed up in the VA health care system from October 1, 2001, to October 1, 2011, were identified using the International Classification of Diseases, Ninth Revision (ICD-9) codes for UC (556.xx). The study was approved by the institutional review board of the Southeast Louisiana Veterans Health Care System.
Study Design
We conducted a retrospective cohort study in which
Results
We identified 37,191 patients with UC followed up in the VA system during the observational period. A total of 325 patients had diagnostic codes for lymphoma in their records. Manual chart review confirmed 253 cases of lymphoma (among them, 111 prevalent cases of lymphoma were excluded). We included only cases of incident lymphoma (occurring during the follow-up period) confirmed by manual chart review in our analysis. Among the remainder of the patients with a diagnostic code for lymphoma, we
Discussion
In this nationwide cohort of patients with UC from the VA health care system, treatment with thiopurines was associated with an approximate 4-fold and 7-fold increase in the risk of lymphoma relative to patients with UC who were not treated with thiopurines and the SEER general population, respectively. These findings are consistent with the previous population-based prospective cohort study reported by Beaugerie et al in 2009.21 Additionally, we have shown that the magnitude of this risk is
Acknowledgments
The study sponsor (the Departmental of Veterans Affairs) has no role in study design analysis, and interpretation of the data and in the writing of the report. The contents of this report do not represent the views of the Department of Veterans Affairs or the US Government.
The authors acknowledge the kind support of Joel and Nancy Barnett Foundation.
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research & Development Health Services (VA Project No. 425).