6-Thioguanine measurement allows optimisation in management of IBD patients on azathioprine

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On tolerability and safety of a maintenance treatment with 6-thioguanine in azathioprine or 6-mercaptopurine intolerant IBD patients.

AIM To determine the tolerability and safety profile of a low-dose maintenance therapy with 6-TG in azathioprine (AZA) or 6-mercaptopurine (6-MP) intolerant inflammatory bowel disease (IBD) patients over a treatment period of at least 1 year. METHODS Database analysis. RESULTS Twenty out of ninety-five (21%) patients discontinued 6-TG (mean dose 24.6 mg; mean 6-TGN level 540 pmol/8 x 10(8) ...

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Hepatotoxicity associated with 6-methyl mercaptopurine formation during azathioprine and 6-mercaptopurine therapy does not occur on the short-term during 6-thioguanine therapy in IBD treatment.

BACKGROUND AND AIMS High concentrations of methylated thiopurine metabolites, such as 6-methyl mercaptopurine, are associated with hepatotoxicity during administration of the conventional thiopurines azathioprine or 6-mercaptopurine in IBD patients. Metabolization of the non-conventional thiopurine 6-thioguanine does not generate 6-methyl mercaptopurine. Hence, the aim of our study was to evalu...

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European experience of 6-thioguanine for azathioprine intolerance in Crohn’s disease

Current treatment for midgut carcinoid includes radical surgery of the primary tumour, resection of lymph node metastases and resection of liver metastases. In the presence of disseminated disease however, cure is unusual. Palliative liver resection and hepatic artery embolisation are also recognised to decrease hormone secretion and reduce tumour volume. Somatostatin analogues reduce the synth...

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Utilisation of erythrocyte 6-thioguanine metabolite levels to optimise azathioprine therapy in patients with inflammatory bowel disease.

BACKGROUND AND AIM The immunosuppressive properties of 6-mercaptopurine and its parent compound azathioprine are mediated by their intracellular metabolism into active 6-thioguanine (6-TG) metabolites. Measurement of erythrocyte 6-TG metabolite levels has been proposed as a useful clinical tool for assessing treatment efficacy in patients with inflammatory bowel disease (IBD). AIM The purpose...

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Azathioprine and mesalazine-induced effects on the mucosal flora in patients with IBD colitis.

BACKGROUND The impact of azathioprine and 5-aminosalicylic acid (5-ASA) on the innate immunity and mucosal flora is unknown. The study investigated the influence of IBD treatment on the concentrations and spatial organization of mucosal bacteria using fluorescence in situ hybridization with 16s r-RNA targeting probes. METHODS We prospectively investigated colonoscopic biopsies from five group...

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ژورنال

عنوان ژورنال: Gut

سال: 2011

ISSN: 0017-5749

DOI: 10.1136/gut.2011.239301.299