Difficulties and possibilities with thiopurine therapy in inflammatory bowel disease-Proceedings of the first Thiopurine Task Force meeting

Dirk P. Van Asseldonk, Jeremy Sanderson, Nanne K.H. de Boer, Miles P. Sparrow, Marc Lémann, Azhar Ansari, Sven H. Almer, Timothy H.J. Florin, Richard B. Gearry, Chris J. Mulder, Gerassimos Mantzaris, Ad A. van Bodegraven

Research output: Contribution to journalArticleResearchpeer-review

36 Citations (Scopus)

Abstract

Background: Thiopurines, such as azathioprine and mercaptopurine, are of pivotal importance in the treatment of inflammatory bowel disease. Although these drugs have been used for several decades, still many questions remain unanswered. Aim: To provide an overview of clinically and scientifically challenging topics concerning thiopurine therapy in inflammatory bowel disease treatment. Methods: The first meeting of the Thiopurine Task Force Interest Group was held during the 2009 United European Gastroenterology Week in London (GASTRO2009). The topics of this meeting were of particular clinical and scientific interest. Additional literature was identified by performing a Pubmed search using the search terms 'inflammatory bowel disease', 'azathioprine', '6-mercaptopurine' and 'thioguanine'. Results: The following topics were discussed: therapeutic drug monitoring; the synergy of thiopurines with aminosalicylates and allopurinol; serious adverse events such as opportunistic infections, hepatotoxicity, carcinogenicity and pancreatitis; prolongation of thiopurines during clinical remission; indications for thiopurines in the postoperative setting; and the potential use of thioguanine. Specific interesting and clinically relevant topics for potential future research are provided. Conclusions: Thiopurines remain central to inflammatory bowel disease treatment, although future studies are required to substantiate a more personalised medicine approach to their use.

Original languageEnglish
Pages (from-to)270-276
Number of pages7
JournalDigestive and Liver Disease
Volume43
Issue number4
DOIs
Publication statusPublished - Apr 2011
Externally publishedYes

Keywords

  • Adverse events
  • Inflammatory bowel disease
  • Therapeutic drug monitoring
  • Thiopurines

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