Open AccessSafety of Thioguanine in Pediatric Inflammatory Bowel Disease
Author(s) -
Bayoumy Ahmed B.,
Jagt Jasmijn Z.,
Wering Herbert M.,
Ridder Lissy,
Hummel Thalia,
Wolters Victorien M.,
Stapelbroek Janneke,
Benninga Marc A.,
Mulder Chris J.J.,
Boer Nanne K.H.,
Meij Tim G.J.
Publication year - 2022
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000003621
Subject(s) - medicine , azathioprine , inflammatory bowel disease , pancreatitis , clostridium difficile , adverse effect , gastroenterology , retrospective cohort study , abdominal pain , pediatrics , disease , antibiotics , microbiology and biotechnology , biology
Objectives: Thioguanine (TG) has been shown as a safe alternative in adults with inflammatory bowel disease (IBD) who did not tolerate conventional thiopurines [azathioprine (AZA)/mercaptopurine]. However, data in pediatric IBD are scarce. Therefore, we aimed to assess the safety of TG as maintenance therapy. Methods: A retrospective, multicenter cohort study of children with IBD on TG was performed in the Netherlands. TG‐related adverse events (AE) were assessed and listed according to the common terminology criteria for AE. Results: Thirty‐six children with IBD (median age 14.5 years) on TG (median dose 15 mg/day) were included in 6 centers. Five AE occurred during follow‐up [pancreatitis (grade 3), hepatotoxicity (grade 3) (n = 2), Clostridium difficile infection (grade 2), and abdominal pain (grade 2)]. All patients (n = 8) with a previously AZA‐induced pancreatitis did not redevelop pancreatitis on TG. Conclusions: In pediatric IBD, TG seems a safe alternative in case of AZA‐induced pancreatitis. Further research assessing long‐term TG‐related safety and efficacy is needed.