Open AccessThioguanine Therapy in Inflammatory Bowel Diseases. A Practical Guide
Author(s) -
Femke Crouwel,
Melek Simsek,
Chris J. Mulder,
Hans J C Buiter,
Nanne K de Boer
Publication year - 2020
Publication title -
journal of gastrointestinal and liver diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.641
H-Index - 48
eISSN - 1842-1121
pISSN - 1841-8724
DOI - 10.15403/jgld-2765
Subject(s) - thiopurine methyltransferase , medicine , azathioprine , inflammatory bowel diseases , adverse effect , incidence (geometry) , inflammatory bowel disease , intensive care medicine , nodular regenerative hyperplasia , mercaptopurine , disease , physics , cirrhosis , optics , portal hypertension
Thiopurine-derivates azathioprine and mercaptopurine are frequently used to maintain remission in inflammatory bowel diseases (IBD). Despite their efficacy, more than 50% of patients discontinue therapy, mainly due to the development of adverse events. Thioguanine is an alternative thiopurine and has been conditionally licensed in The Netherlands as IBD treatment for patients after conventional thiopurine therapy failure. In this review we will provide practical information on initiating and maintaining thioguanine therapy in IBD and provide information concerning safety issues and future perspectives. The thioguanine toxicity profile is relatively mild and the reported incidence of nodular regenerative hyperplasia related to thioguanine use seems comparable to conventional thiopurines and the background incidence in IBD patients. Routine monitoring of laboratory parameters and adverse events is recommended, comparable to the monitoring of patients on conventional thiopurine therapy.