Use of thiopurines in inflammatory bowel disease |
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Authors: | Pascal Frei Luc Biedermann Ole Haagen Nielsen Gerhard Rogler |
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Affiliation: | Pascal Frei, Luc Biedermann, Gerhard Rogler, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital of Zürich, CH-8091 Zürich, SwitzerlandOle Haagen Nielsen, Department of Gastroenterology, Medical Section, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark |
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Abstract: | 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. |
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Keywords: | Thiopurines Inflammatory bowel disease Crohn’s disease Ulcerative colitis Immunosuppression Infection |
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