Article
Gastroenterology & Hepatology
Raphael P. Luber, Luke Dawson, Stephanie Munari, Viraj C. Kariyawasam, Catherine Martin, Peter R. Gibson, Miles P. Sparrow, Mark G. Ward
Summary: Combination therapy with optimized thiopurines was superior to infliximab monotherapy in inducing and maintaining response in the first 6 months in Crohn's disease. However, there was no clinical advantage to combination therapy in maintenance beyond the initial period, suggesting individualized consideration for thiopurine withdrawal. Therapeutic TGN levels were associated with higher remission rates and improved outcomes in Crohn's disease treatment.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Review
Medicine, General & Internal
Carla J. Gargallo-Puyuelo, Viviana Laredo, Fernando Gomollon
Summary: Thiopurines play a crucial role in the treatment of IBD, but there are still unresolved issues regarding their efficacy and safety. Personalized therapy based on pharmacogenomics and genetic polymorphisms of metabolizing enzymes may help prevent side effects. Factors such as age, ethnicity, and viral infections also influence the outcomes of thiopurine therapy.
FRONTIERS IN MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Femke Crouwel, Melek Simsek, Marjon A. de Boer, Chris J. J. Mulder, Emma M. van Andel, Rob H. Creemers, Dirk P. van Asseldonk, Ad A. van Bodegraven, Carmen S. Horjus, Marijn C. Visschedijk, Angelique L. M. Weusthuis, Margien L. Seinen, Bindia Jharap, Fiona D. M. van Schaik, Ishfaq Ahmad, Paul J. Boekema, Greetje J. Tack, Louktje Wormmeester, Maurice W. M. D. Lutgens, Petra G. A. van Boeckel, Lennard P. L. Gilissen, Marjon Kerkhof, Maurice G. V. M. Russel, Frank Hoentjen, Maartje E. Bartelink, Johan P. Kuijvenhoven, Jeroen W. J. Maljaars, Willemijn A. van Dop, Janneke Wonders, Michael M. P. J. A. van der Voorn, Hans J. C. Buiter, Nanne K. de Boer
Summary: This study aimed to assess the safety of thioguanine use during pregnancy. Data from 117 thioguanine-exposed pregnancies were collected, and the majority of patients had Crohn's disease. Few pregnancies had complications or resulted in neonatal abnormalities.
JOURNAL OF CROHNS & COLITIS
(2023)
Review
Pharmacology & Pharmacy
Keiichi Tominaga, Takeshi Sugaya, Takanao Tanaka, Mimari Kanazawa, Makoto Iijima, Atsushi Irisawa
Summary: Thiopurines are medications used to treat inflammatory bowel diseases, particularly ulcerative colitis, with the potential to alleviate symptoms and maintain long-term remission. Careful monitoring is needed for adverse events associated with long-term use, while these drugs also play a critical role in controlling immunogenicity and predicting serious adverse events. However, the consequences of thiopurine withdrawal remain uncertain and further research is required to address this clinical question.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Medical Laboratory Technology
Ahmed B. Bayoumy, Chris J. J. Mulder, Aathavan Loganayagam, Jeremy D. Sanderson, Simon Anderson, Paul J. Boekema, Luc J. J. Derijks, Azhar R. Ansari
Summary: The study findings suggest that TPMT measurements at TG initiation may be beneficial but not essential in daily practice for patients with IBD. TPMT genotypes and phenotypes are both linked to significant differences in 6-TGN levels between metabolic groups. The advantage of TG is that RBC 6-TGN measurements are not essential for monitoring treatments, particularly in countries where diagnostic tests are not readily accessible.
THERAPEUTIC DRUG MONITORING
(2021)
Article
Medicine, General & Internal
Ali Eqbal, Alicia Martin, James D. Doecke, Desmond Patrick
Summary: This study evaluated the short-term efficacy and safety of low-dose therapeutic drug-monitored (TDM) thioguanine in patients with inflammatory bowel disease. The results showed that thioguanine was well tolerated in 63% of patients, with a clinical response rate of 62% and a high maintenance of remission rate at 76%.
INTERNAL MEDICINE JOURNAL
(2023)
Article
Gastroenterology & Hepatology
Paula Sousa, Paula Ministro, Alessandro Armuzzi, Axel Dignass, Marte Lie Hoivik, Manuel Barreiro-de Acosta, Stephan Vavricka, Rogerio Saad-Hossne, Paulo Gustavo Kotze, Laurent Peyrin-Biroulet, Fernando Magro
Summary: Majority of surveyed IBD physicians use thiopurines for treating CD and UC, considering them to have good safety profile. Despite emerging treatments, most physicians believe that thiopurines will remain an important part of the treatment algorithm for CD and UC.
DIGESTIVE AND LIVER DISEASE
(2021)
Article
Gastroenterology & Hepatology
Uma Mahadevan, Millie D. Long, Sunanda Kane, Abhik Roy, Marla C. Dubinsky, Bruce E. Sands, Russell D. Cohen, Christina D. Chambers, William J. Sandborn
Summary: The study found that exposure to biologic, thiopurine, or combination therapy during pregnancy did not increase adverse maternal or fetal outcomes, and these treatments can be continued throughout pregnancy for women with IBD to maintain disease control.
Article
Pharmacology & Pharmacy
Tiphaine Adam de Beaumais, Simon Lorrain, Naura Mamhoudi, Mathieu Simonin, Christine Martinez Vinson, Yves Medard, Arnaud Petit, Evelyne Jacqz-Aigrain
Summary: This study investigates the factors affecting the concentrations of red blood cell metabolites in children to facilitate therapeutic drug monitoring. The results show that many children did not reach the target concentration range, and adjusting the dosage may help improve treatment outcomes.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2023)
Review
Environmental Sciences
Oliwia Zakerska-Banaszak, Liliana Lykowska-Szuber, Michal Walczak, Joanna Zuraszek, Aleksandra Zielinska, Marzena Skrzypczak-Zielinska
Summary: The effectiveness of thiopurine drugs in inflammatory bowel disease (IBD) has been confirmed for more than 50 years. Despite controversies over their cytotoxic properties and adverse effects, thiopurines are still widely used for maintaining remission in Crohn's disease and ulcerative colitis. Further research is needed to explore the modulation of thiopurine action in combination therapy and their interaction with the gut microbiota.
Article
Gastroenterology & Hepatology
Mukesh Kumar Ranjan, Sudheer Kumar Vuyyuru, Bhaskar Kante, Peeyush Kumar, Sandeep K. Mundhra, Rithvik Golla, Raju Sharma, Peush Sahni, Prasenjit Das, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Summary: Approximately 50% of patients with IBD in remission would relapse after 5 years of thiopurine withdrawal. Male sex and shorter treatment duration predict relapse.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2022)
Article
Gastroenterology & Hepatology
Femke Crouwel, Ahmed B. Bayoumy, Chris J. J. Mulder, Job H. C. Peters, Paul J. Boekema, Luc J. J. Derijks, Sybrand Y. de Boer, Paul C. van de Meeberg, Ishfaq Ahmad, Hans J. C. Buiter, Nanne K. de Boer
Summary: This study aimed to evaluate the safety, effectiveness, and 12-month drug survival of first-line thioguanine therapy in thiopurine-naive patients with inflammatory bowel disease. The results showed that at 12 months, 53% of patients had a clinical response to thioguanine therapy and 86% of patients continued using thioguanine after 12 months. Only 8% of patients discontinued therapy due to adverse events.
INFLAMMATORY BOWEL DISEASES
(2023)
Letter
Gastroenterology & Hepatology
Flora Maria Lorenzo Fortes, Raquel Rocha, Genoile Oliveira Santana
Summary: The use of thiopurines increases the risk of active tuberculosis in patients with inflammatory bowel disease.
WORLD JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Gastroenterology & Hepatology
Antoine Meyer, Marion Taine, Jerome Drouin, Alain Weill, Franck Carbonnel, Rosemary Dray-Spira
Summary: This study compared the risk of serious infections in children with in utero exposure to thiopurines and/or anti-TNF born to mothers with inflammatory bowel disease (IBD). The results showed that in the first 5 years of life, children exposed to thiopurine monotherapy and anti-TNF monotherapy had similar risks of serious infections compared to unexposed children, while children exposed to combination therapy had a higher risk.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Doriane Broussard, Pauline Riviere, Joelle Bonnet, Ginette Fotsing, Aurelien Amiot, Laurent Peyrin-Biroulet, Sylvie Rajca, Anthony Buisson, Cyrielle Gilleta, Anne-Laure Pelletier, Melanie Serrero, Guillaume Bouguen, Romain Altwegg, Xavier Hebuterne, Stephane Nancey, Mathurin Fumery, Guillaume Cadiot, Stephane Nahon, Jean-Francois Rahier, Jean-Marc Gornet, Veronique Vendrely, David Laharie
Summary: A retrospective multicentre study was conducted to assess the impact of abdominal or pelvic radiotherapy on IBD course. Most patients with non-active IBD can be safely treated with radiotherapy, but patients with acute gut toxicity and without concomitant chemotherapy should be more closely monitored post-radiotherapy.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2021)
