Goel Rishi M, Blaker Paul, Mentzer Alex, Fong Steven C M, Marinaki Anthony M, Sanderson Jeremy D
Guy's & St Thomas' Hospitals - Gastroenterology, Westminster Bridge Road, London SE1 7EH, UK.
Guy's & St Thomas' Hospitals - Gastroenterology, London, UK.
Ther Adv Chronic Dis. 2015 May;6(3):138-46. doi: 10.1177/2040622315579063.
Immunomodulator drugs, of which thiopurines can be considered the backbone, are widely used in the treatment of inflammatory bowel disease. They have been shown to be highly effective and safe; however, a significant proportion of patients are deemed to have a poor response or suffer adverse reactions. Knowing how to monitor and optimize thiopurine therapy in these scenarios is crucial to effective management. We discuss the metabolism of thiopurines, the use of enzyme/metabolite testing to guide treatment, as well as strategies to circumvent toxicity and side effects, such as allopurinol coprescription. The indications, use in pregnancy, safety profile and duration of thiopurine therapy are also discussed.
免疫调节药物，其中硫嘌呤类药物可被视为基础药物，广泛用于治疗炎症性肠病。这些药物已被证明具有高效性和安全性；然而，相当一部分患者被认为反应不佳或出现不良反应。了解在这些情况下如何监测和优化硫嘌呤治疗对于有效管理至关重要。我们讨论了硫嘌呤的代谢、使用酶/代谢物检测来指导治疗，以及规避毒性和副作用的策略，如联合使用别嘌醇。还讨论了硫嘌呤治疗的适应症、孕期使用情况、安全性概况和疗程。
