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• W1499725388 abstract "Thiopurines, or purine analogues, are immunomodulators used in the treatment of malignancies,rheumatic diseases, dermatologic conditions, inflammatory bowel disease and in solid organtransplantation. These agents include azathioprine (AZA), mercaptopurine (6-MP) and thioguanine (6-TG). Thiopurines are converted by the enzyme thiopurine methyltransferase (TPMT) into metabolites.Measurement of TPMT activity may help identify patients at risk for excessive toxicity, most oftenmyelosuppression, after receiving standard doses of thiopurine medications. Measurement ofmetabolites (metabolite markers) may help tailor individualized drug therapy.Azathioprine, which is a prodrug of 6-mercaptopurine (6-MP), is considered an effectiveimmunosuppressive treatment of inflammatory bowel disease, particularly in patients with steroidresistantdisease. For example, in the course of 1 year, 50% of patients with Crohn’s disease will requiresteroids for its treatment; of these, 50% will either be steroid resistant or steroid dependent, and thuscandidates for immunosuppressive therapy. Azathioprine therapy eliminates the need for corticosteroidsin about 75% of patients; azathioprine is also considered an effective therapy for fistulizing disease.Results: A recent randomized clinical trial of children with Crohn’s disease suggests that compared toprednisone alone, the inclusion of azathioprine with prednisone at the time of initial diagnosis isassociated with improved maintenance of remission, while simultaneously decreasing the dose ofprednisone.However, the use of azathioprine is limited by both its long onset of action (3–4 months) and drugtoxicities, which include hepatotoxicity, bone marrow suppression, pancreatitis and allergic reactions.Long-term drug use has been associated with neoplasia.Objective: The purpose of this comprehensive review is to suggest guidelines for the application ofazathioprine and 6-mercaptopurine in the treatment of inflammatory bowel disease." @default.
• W1499725388 created "2016-06-24" @default.
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• W1499725388 date "2010-10-03" @default.
• W1499725388 modified "2023-09-24" @default.
• W1499725388 title "Thiopurines Treatment for Inflammatory Bowel Disease in Current Clinical Practice(Review Articles)" @default.
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