Efficacy and safety of 6-thioguanine in the management of inflammatory bowel disease

Scandinavian Journal of Gastroenterology

Volumn 42, Issue 2, 2007, Pages 194-199

  Qasim, Asghar ^a   McDonald, Sharon ^a   Sebastian, Shaji ^a   McLoughlin, Ramona ^a   Buckley, Martin ^a   O'Connor, Humphrey ^a   O'Morain, Colm ^a  

^a ADELAIDE AND MEATH HOSPITAL   (Ireland)

Author keywords

6 thioguanine; Hepatic nodular regenerative hyperplasia; Inflammatory bowel disease; Thiopurine analogues; Thrombocytopenia

Indexed keywords

6 MERCAPTOPURINE DERIVATIVE; AZATHIOPRINE; BIOLOGICAL MARKER; CORTICOSTEROID; MERCAPTOPURINE; MESALAZINE; STEROID; TIOGUANINE;

ADULT; AGED; ALANINE AMINOTRANSFERASE BLOOD LEVEL; ALBUMIN BLOOD LEVEL; ALKALINE PHOSPHATASE BLOOD LEVEL; ARTICLE; BILIRUBIN BLOOD LEVEL; CLINICAL ARTICLE; CLINICAL TRIAL; COLITIS; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CROHN DISEASE; DISEASE MARKER; DRUG EFFICACY; DRUG INDICATION; DRUG SAFETY; DRUG TOLERABILITY; DRUG USE; DRUG WITHDRAWAL; ENTERITIS; FEMALE; GAMMA GLUTAMYL TRANSFERASE BLOOD LEVEL; HUMAN; INFLAMMATION; LABORATORY TEST; LEUKOCYTE COUNT; LIVER FUNCTION TEST; LIVER TOXICITY; MALE; MEDICAL PARAMETERS; MYALGIA; NEUTROPHIL COUNT; OBSERVATIONAL STUDY; PHARMACOLOGICAL PARAMETERS; PRIORITY JOURNAL; PROSPECTIVE STUDY; REMISSION; SIDE EFFECT; SPLENOMEGALY; STEROID THERAPY; THERAPY RESISTANCE; THROMBOCYTE COUNT; THROMBOCYTOPENIA; TREATMENT DURATION; TREATMENT OUTCOME; ULCERATIVE COLITIS; VOMITING;

ADOLESCENT; ADULT; AGED; ANTIMETABOLITES, ANTINEOPLASTIC; DOSE-RESPONSE RELATIONSHIP, DRUG; FEMALE; FOLLOW-UP STUDIES; HUMANS; INFLAMMATORY BOWEL DISEASES; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; REMISSION INDUCTION; THIOGUANINE; TREATMENT OUTCOME;

EID: 33846945389     PISSN: 00365521     EISSN: 15027708     Source Type: Journal    
DOI: 10.1080/00365520600825166     Document Type: Article

References (27)

1. Pearson C, May GR, Fick GH, Sutherland LR. Azathioprine and 6-mercaptopurine in Crohn's disease. A meta-analysis. Ann Intern Med 1995;123:132-42.
2. George J, Present DH, Pou R, Bodian C, Rubin PH. The long-term outcome of ulcerative colitis treated with 6-mercaptopurine. Am J Gastroenterol 1996;91:1711-4.
3. Lennard L. The clinical pharmacology of 6-mercaptopurine. Eur J Clin Pharmacol 1992;43:329-39.
4. Cuffari C, Theoret Y, Latour S, Seidman G. 6-Mercaptopurine metabolism in Crohn's disease: correlation with efficacy and toxicity. Gut 1996;39:401-6.
5. Korelitz BI, Zlantanic J, Goel F, Fuller S. Allergic reactions to 6-mercaptopurine in the management of inflammatory bowel disease. J Clin Gastroenterol 1999;28:341-4.
6. Present DH, Meltzer SJ, Krumholz MP, Wolke A, Korelitz BI. 6-mercaptopurine in the management of inflammatory bowel disease: short and long-term toxicity. Ann Intern Med 1989;111:641-9.
7. Connell WR, Kamm MA, Ritchie JK, Lennard-Jones JE. Bone marrow toxicity caused by azathioprine in inflammatory bowel disease: 27 years of experience. Gut 1993;34: 1081-5.
8. Sandborn W, Sutherland L, Pearson D, May G, Modigliani R, Prantera C. Azathioprine or 6-mercaptopurine for inducing remission of Crohn's disease. Cochrane Database Syst Rev 2001;3.
9. Steinhart AH, Hawkey CJ, Modigliani R. 6-Mercaptopurine and azathioprine for maintaining remission in ulcerative colitis. Cochrane Database Syst Rev 2001; 3.
10. Bouhnik Y, Lemann M, Nary JY, Scemama G, Tai R, Matuchansky C, et al. Long-term follow-up of patients with Crohn's disease treated with azathioprine or 6-mercaptopurine. Lancet 1996;347:215-9.
11. Munkholm P, Langholz E, Davidsen M, Binder V. Disease activity courses in a regional cohort of Crohn's disease patients. Scand J Gastroenterol 1995;30:699-706.
12. Dubinsky MC, Hassard PV, Seidman EG, Kam LY, Abreu MT, Targan SR, et al. An open-label pilot study using thioguanine as a therapeutic alternative in Crohn's disease patients resistant to 6-mercaptopurine therapy. Inflamm Bowel Dis 2001;7:190-1.
13. Derijks JJL, de Jong JD, Gilissen PLL, Engels GJBL, Hooymans MP, Jansen BMJJ, et al. 6-Thioguanine seems promising in azathioprine- or 6-mercaptopurine-intolerant inflammatory bowel disease patients: a short-term safety assessment. Eur J Gastroenterol Hepatol 2003;15:63-7.
14. Herrlinger KR, Deibert P, Schwab M, Kreisel W, Fischer C, Fellermann K, et al. Remission maintenance by thioguanine in chronic active Crohn's disease. Aliment Pharmacol Ther 2003;17:1459-64.
15. Bonaz B, Boitard J, Marteau P, Lemann M, Coffin B, Flourie B, et al. Thioguanine in patients with Crohn's disease intolerant or resistant to azathioprine/mercaptopurine. Aliment Pharmacol Ther 2003;15:401-8.
16. Herrlinger KR, Kreisel W, Schwab M, Schoelmerich J, Fleig WE, Ruhl A, et al. 6-thioguanine: efficacy and safety in chronic active Crohn's disease. Aliment Pharmacol Ther 2003;17:503-8.
17. Dubinsky MC, Feldman EJ, Abreu MT, Targan SR, Vasiliaukas EA. Thioguanine (6-TG): a potential alternate thiopurine for IBD patients allergic to 6-mercaptopurine or azathioprine. Am J Gastroenterol 2003;98:1058-63.
18. Shastri S, Dubinsky MC, Fred Poordad S, Vasiliauskas EA, Geller SA. Early nodular hyperplasia occurring with inflammatory bowel disease in association with thioguanine therapy. Arch Pathol Lab Med 2004;128:49-53.
19. Kane S, Cohen SM, Hart J. Acute sinusoidal obstruction syndrome after 6-thioguanine therapy in Crohn's disease. Inflamm Bowel Dis 2004;10:652-4.
20. Ibarrola C, Castellano VM, Colina F. Focal hyperplastic hepatocellular nodules in hepatic venous outflow obstruction: a clinicopathological study of four patients and 24 nodules. Histopathology 2004;44:172-9.
21. Dubinsky MC, Vasiliauskas EA, Singh H, Abreu MT, Papadakis KA, Tran T, et al. 6-Thioguanine can cause serious liver injury in inflammatory bowel disease. Gastroenterology 2003;125:298-303.
22. Geller SA, Dubinsky MC, Poordad FF, Vasiliauskas EA, Cohen AH, Abreu MT, et al. Early nodular hyperplasia and submicroscopic fibrosis associated with 6-thioguanine therapy in IBD. Am J Surg Pathol 2004;28:1204-11.
23. Seiderer J, Zech CJ, Reinisch W, Lukas M, Diebold J, Wrba F, et al. A multicenter assessment of liver toxicity by MRI and biopsy in IBD patients on 6-thioguanine. J Hepatol 2005;43:303-9.
24. Myren J, Bouchier IAD, Watkinson, Softley A, Clamp SE, Dombal FT. The O.M.G.E. multinational inflammatory bowel disease survey 1976-1982. A further report on 2657 cases. Scand J Gastroenterol 1984; Suppl 95:1-27.
25. Lichtiger S, Present DH, Kornbluth A, Gelernt I, Bauer J, Galler G, et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med 1994;330:1841-5.
26. Stoneham S, Lennard L, Coen P, Lilleyman J, Saha V. Venoocclusive disease in patients receiving thioguanines during maintenance therapy for childhood acute lymphoblastic leukaemia. Br J Haematology 2003;123:100-2.
27. Dubinsky MC, Yang H, Hassard PV, Seidman EG, Kam LY, Abreu MT, et al. 6-MP metabolite profiles provide a biochemical explanation for 6-MP resistance in patients with inflammatory bowel disease. Gastroenterology 2002; 122:904-15.