M. Sparrow

Azathioprine and allopurinol: A two‐edged interaction

The thiopurines, azathioprine and 6-mercaptopurine (6-MP), are immunosuppressive drugs used in a number of clinical settings, such as following transplantation and for the management of inflammatory conditions like inflammatory bowel disease (IBD). Allopurinol, a xanthine oxidase inhibitor used in the treatment of gout, is not infrequently coincidentally co-prescribed with the thiopurines. A recent safety report from the New South Wales Department of Health (NSW, Australia) highlights the potential risk with the co-administration of these two drugs. This commentary reviews the interaction of these drugs and highlights important precautions that should be taken by clinicians when using them together.

P342 Adalimumab prevents post-operative Crohn's disease recurrence and is superior to thiopurines: Early results from the prospective POCER study

unaffected by TPMT (30.8 vs 33.0 pmol/hb/ml, p = 0.16), site of disease, behaviour, family history, smoking, surgery or, extraintestinal manifestations. Conclusions: Consistent with previous data, this, the largest series to date, with substantial follow-up, has shown that MP is a safe alternative for up to 60% of AZA-I patients, including some with a previous major intolerance. Patients with previous gastrointestinal intolerance or hepatotoxicity may be more likely to tolerate a trial of MP.

DOP064 Faecal calprotectin is superior to faecal lactoferrin and S100A12

DOP064 Faecal calprotectin is superior to faecal lactoferrin and S100A12 E.K. Wright1 *, P.P. De Cruz1, M.A. Kamm1, A.L. Hamilton1, K.J. Ritchie1, E.O. Krejany1, S.T. Leach2, J.I. Keenan2, A. Gorelik1, D. Liew1, L. Prideaux1, I.C. Lawrance1, J.M. Andrews1, P.A. Bampton1, M.P. Sparrow1, T.H. Florin1, P.R. Gibson1, H.S. Debinski1, F.A. Macrae1, R.W. Leong1, I.J. Kronborg1, G.L. Radford-Smith1, W.S. Selby1, M.J. Johnson1, R.J. Woods1, P.R. Elliott1, S.J. Bell1, S.J. Brown1, W.R. Connell1, A.S. Day2, R.B. Gearry2, P.V. Desmond1. 1St Vincent’s Hospital & University of Melbourne, Gastroenterology, Melbourne, Australia, 2Christchurch Hospital, Gastroenterology, Christchurch, New Zealand

DOP041 Intra-uterine ExposuRe to Anti-TNF-alpha therapy (ERA study): Infliximab and adalimumab cord blood levels correlate with maternal levels at birth

Methods: A systematic literature search was conducted to identify studies that investigated the pregnancy outcomes among women with IBD on anti-TNF-a therapy. The primary outcome was the overall rate of unfavourable pregnancyrelated outcomes among women with IBD on anti-TNF-a therapy. Secondary outcomes included rates of abortions (spontaneous or elective), preterm delivery, low birth weight, and congenital malformations. Odds ratios (OR) with 95%CI are reported. Studies included met the following criteria: observational or treatment design; had subjects with IBD on anti-TNF-a therapy for at least one trimester; and comparison with appropriately matched controls. Results: Overall, five studies with a total of 1216 participants were eligible for inclusion in the meta-analysis. There was no significant difference in the rates of total unfavourable pregnancy outcomes between pregnant women with IBD who were on anti-TNF-a therapy compared to controls not on antiTNF-a therapy (OR 1.12, 95%CI 0.79 1.59) (Figure 1). Similarly, there were no statistically significant differences in the rates of abortion (OR 1.48, 95%CI 0.93 2.35), preterm birth (OR 1.00, 95%CI 0.62 1.62), low birth weight (OR 1.05, 95%CI 0.62 1.78), or congenital malformation (OR 1.10, 95%CI 0.58 2.09) (Figure 2). Conclusions: The use of anti-TNF-a therapy does not appear to increase the risk of unfavourable pregnancy outcomes among women with IBD, although the optimal timing of therapy through pregnancy and the post-partum period was not assessed in this analysis. This data can help counsel patients around family planning and perinatal management.