Department of Gastroenterology and Hepatology, AGEM Research Institute, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
J Gastrointestin Liver Dis. 2020 Dec 13;29(4):637-645. doi: 10.15403/jgld-2765.
Thiopurine-derivates azathioprine and mercaptopurine are frequently used to maintain remission in inflammatory bowel diseases (IBD). Despite their efficacy, more than 50% of patients discontinue therapy, mainly due to the development of adverse events. Thioguanine is an alternative thiopurine and has been conditionally licensed in The Netherlands as IBD treatment for patients after conventional thiopurine therapy failure. In this review we will provide practical information on initiating and maintaining thioguanine therapy in IBD and provide information concerning safety issues and future perspectives. The thioguanine toxicity profile is relatively mild and the reported incidence of nodular regenerative hyperplasia related to thioguanine use seems comparable to conventional thiopurines and the background incidence in IBD patients. Routine monitoring of laboratory parameters and adverse events is recommended, comparable to the monitoring of patients on conventional thiopurine therapy.
硫嘌呤衍生物巯嘌呤和硫唑嘌呤常用于维持炎症性肠病（IBD）的缓解。尽管它们具有疗效，但超过 50%的患者停止治疗，主要是由于发生了不良反应。硫鸟嘌呤是一种替代的硫嘌呤，在荷兰被有条件批准作为常规硫嘌呤治疗失败后的 IBD 治疗药物。在这篇综述中，我们将提供关于在 IBD 中启动和维持硫鸟嘌呤治疗的实用信息，并提供有关安全性问题和未来展望的信息。硫鸟嘌呤的毒性谱相对较轻，据报道与硫鸟嘌呤使用相关的结节性再生性增生的发生率与常规硫嘌呤相当，且与 IBD 患者的背景发生率相当。建议常规监测实验室参数和不良反应，与监测常规硫嘌呤治疗的患者类似。
