Use of thiopurines in inflammatory bowel disease

被引：23

作者：

Frei, Pascal ^{[1
]}

Biedermann, Luc ^{[1
]}

Nielsen, Ole Haagen ^{[2
]}

Rogler, Gerhard ^{[1
]}

机构：

[1] Univ Zurich Hosp, Dept Internal Med, Div Gastroenterol & Hepatol, CH-8091 Zurich, Switzerland

[2] Univ Copenhagen, Herlev Hosp, Dept Gastroenterol, Med Sect, DK-2730 Herlev, Denmark

来源：

WORLD JOURNAL OF GASTROENTEROLOGY | 2013年 / 19卷 / 07期

关键词：

Thiopurines; Inflammatory bowel disease; Crohn's disease; Ulcerative colitis; Immunosuppression; Infection; NODULAR REGENERATIVE HYPERPLASIA; 6-THIOGUANINE NUCLEOTIDE CONCENTRATIONS; AZATHIOPRINE-INTOLERANT PATIENTS; S-METHYLTRANSFERASE ACTIVITY; NONMELANOMA SKIN-CANCER; LOW-DOSE; 6-THIOGUANINE; CROHNS-DISEASE; DOUBLE-BLIND; LONG-TERM; CONTROLLED-TRIAL;

D O I：

10.3748/wjg.v19.i7.1040

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, including the combination of azathioprine and allopurinol, switching of thiopurine therapy in case of side effects, the use of azathioprine in pregnancy, the infection risk using thiopurines and the evidence when to stop thiopurines. Excellent reviews have been published on the thiopurine metabolic pathway which will not be discussed here in detail. (C) 2013 Baishideng. All rights reserved.

引用

页码：1040 / 1048

页数：9

共 99 条

[71] 6-MERCAPTOPURINE IN THE MANAGEMENT OF INFLAMMATORY BOWEL-DISEASE - SHORT-TERM AND LONG-TERM TOXICITY [J].

PRESENT, DH ;

MELTZER, SJ ;

KRUMHOLZ, MP ;

WOLKE, A ;

KORELITZ, BI .

ANNALS OF INTERNAL MEDICINE, 1989, 111 (08) :641-649

[72] Azathioprine dose escalation in inflammatory bowel disease [J].

Rayner, CK ;

Hart, AL ;

Hayward, CMM ;

Emmanuel, AV ;

Kamm, MA .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2004, 20 (01) :65-71

[73]

Reenaers C, 2012, J CROHNS COLITIS, V6, pS8, DOI [10.1016/S1873-9946(12)60016-6, DOI 10.1016/S1873-9946(12)60016-6]

[74] A Multicenter, Randomized, Double-Blind Trial of Everolimus Versus Azathioprine and Placebo to Maintain Steroid-Induced Remission in Patients With Moderate-to-Severe Active Crohn's Disease [J].

Reinisch, Walter ;

Panes, Julian ;

Lemann, Marc ;

Schreiber, Stefan ;

Feagan, B. ;

Schmidt, Steven ;

Sturniolo, Giacomo C. ;

Mikhailova, T. ;

Alexeeva, Olga ;

Sanna, L. ;

Haas, T. ;

Korom, S. ;

Mayer, H. .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2008, 103 (09) :2284-2292

[75] Azathioprine versus mesalazine for prevention of postoperative clinical recurrence in patients with Crohn's disease with endoscopic recurrence: efficacy and safety results of a randomised, double-blind, double-dummy, multicentre trial [J].

Reinisch, Walter ;

Angelberger, Sieglinde ;

Petritsch, Wolfgang ;

Shonova, Olga ;

Lukas, Milan ;

Bar-Meir, Simon ;

Teml, Alexander ;

Schaeffeler, Elke ;

Schwab, Matthias ;

Dilger, Karin ;

Greinwald, Roland ;

Mueller, Ralph ;

Stange, Eduard F. ;

Herrlinger, Klaus R. .

GUT, 2010, 59 (06) :752-759

[76] Clinical Pharmacogenetics Implementation Consortium Guidelines for Thiopurine Methyltransferase Genotype and Thiopurine Dosing [J].

Relling, M. V. ;

Gardner, E. E. ;

Sandborn, W. J. ;

Schmiegelow, K. ;

Pui, C-H ;

Yee, S. W. ;

Stein, C. M. ;

Carrillo, M. ;

Evans, W. E. ;

Klein, T. E. .

CLINICAL PHARMACOLOGY & THERAPEUTICS, 2011, 89 (03) :387-391

[77] Gastrointestinal and liver adverse effects of drugs used for treating IBD [J].

Rogler, Gerhard .

BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY, 2010, 24 (02) :157-165

[78] CONTROLLED TRIAL OF AZATHIOPRINE IN CROHNS-DISEASE [J].

ROSENBERG, JL ;

LEVIN, B ;

WALL, AJ ;

KIRSNER, JB .

AMERICAN JOURNAL OF DIGESTIVE DISEASES, 1975, 20 (08) :721-726

[79]

Sandborn WJ, 1996, AM J GASTROENTEROL, V91, P423

[80]

Seinen ML, 2010, J GASTROINTEST LIVER, V19, P291

← 1 2 3 4 5 6 7 8 9 10 →