Abstract Background Treatment with thiopurines in patients Inflammatory Bowel Disease (IBD) may be associated different adverse effects, including acute pancreatitis. Our aims were to evaluate the clinical presentation, severity and management of pancreatitis related IBD. Methods IBD secondary treatment for identified from prospectively maintained ENEIDA registry Spanish Working Group on Crohn'...

BACKGROUND Thiopurines are the prerequisite for immunomodulation in inflammatory bowel disease (IBD) therapy. When administered in high (oncological) dose, thiopurine metabolites act as purine antagonists, causing DNA-strand breakage and myelotoxicity. In lower IBD dosages, the mode of action is primarily restricted to anti-inflammatory effects. Then, myelosuppression and hepatotoxicity are the...

The thiopurines azathioprine and 6-mercaptopurine (6-MP) are effective immune modulators and cytotoxic agents extensively used in the treatment of autoimmune diseases, graft rejection, and cancer. There is compelling epidemiologic evidence that thiopurine treatment increases the risk for a variety of tumors by mechanisms that are unclear. We investigated the in vivo mutagenicity of long-term th...

Beyond these insights there are further applications and future challenges Sir, Insights into the genetic susceptibility to Crohn's disease (CD) 1 would be incomplete without recognition that the unrivalled success of azathioprine in inducing and maintaining remission in corticoster-oid-dependent CD 2 ought to go hand in hand with a wider application of pharmacogenetic testing 3 so as to optimi...

ferred from the fact that other maintenance treatments such as biologics should be considered in refractory UC patients treated with high-dose corticosteroids. Mucosal healing (MH) is becoming more widely accepted as a relevant outcome marker for UC. In a Norwegian population-based cohort study examining effects between the presence or absence of MH and long-term outcomes, MH at 1 year was conf...

BACKGROUND AND AIMS Allopurinol has been presented as a safe and effective adjunct to thiopurine therapy in inflammatory bowel disease (IBD). We aimed to determine the rate of infectious complications and clinical successes with a combination of thiopurine/allopurinol in IBD, and to identify which variables predict 6-thioguanine, 6-methylmercaptopurine, and white blood cell levels. Additionally...

BACKGROUND In a small number of cases of childhood atopic dermatitis, topical therapy is ineffective, necessitating prolonged use of systemic immunosuppressants. Over the last few years, a better understanding of the metabolic pathways involved in azathioprine breakdown has enabled us to use this drug more safely. In this study, we evaluated the toxicity of azathioprine treatment adjusted to th...

1. Reinshagen M, Schutz E, Armstrong VW, Behrens C, von Tirpitz C, Stallmach A, et al. 6-thioguanine nucleotide-adapted azathioprine therapy does not lead to higher remission rates than standard therapy in chronic active Crohn disease: results from a randomized, controlled, open trial. Clin Chem 2007;53:1306–14. 2. Shipkova M, Armstrong VW, Wieland E, Oellerich M. Differences in nucleotide hydr...

The thiopurines, 6-mercaptopurine (6-MP) and 6-thioguanine (6-TG), are used in the treatment of leukemia. Incorporation of deoxythioguanosine nucleotides (dG) into the DNA of thiopurine-treated cells causes cell death, but there is also evidence that thiopurine metabolites, particularly the 6-MP metabolite methylthioinosinemonophosphate (MeTIMP), inhibit de novo purine synthesis (DNPS). The tox...

The impact of thiopurine methyltransferase (TPMT) genotype on thiopurine dose intensity, myelosuppression and treatment outcome was investigated in the United Kingdom childhood acute lymphoblastic leukaemia (ALL) trial ALL97. TPMT heterozygotes had significantly more frequent cytopenias and therefore required dose adjustments below target levels significantly more often than TPMT wild-type pati...