From the Faculty of Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
the Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
J Pediatr Gastroenterol Nutr. 2022 Dec 1;75(6):e111-e115. doi: 10.1097/MPG.0000000000003621. Epub 2022 Sep 20.
Thioguanine (TG) has been shown as a safe alternative in adults with inflammatory bowel disease (IBD) who did not tolerate conventional thiopurines [azathioprine (AZA)/mercaptopurine]. However, data in pediatric IBD are scarce. Therefore, we aimed to assess the safety of TG as maintenance therapy.
A retrospective, multicenter cohort study of children with IBD on TG was performed in the Netherlands. TG-related adverse events (AE) were assessed and listed according to the common terminology criteria for AE.
Thirty-six children with IBD (median age 14.5 years) on TG (median dose 15 mg/day) were included in 6 centers. Five AE occurred during follow-up [pancreatitis (grade 3), hepatotoxicity (grade 3) (n = 2), Clostridium difficile infection (grade 2), and abdominal pain (grade 2)]. All patients (n = 8) with a previously AZA-induced pancreatitis did not redevelop pancreatitis on TG.
In pediatric IBD, TG seems a safe alternative in case of AZA-induced pancreatitis. Further research assessing long-term TG-related safety and efficacy is needed.
已有研究表明，对于不耐受传统硫嘌呤类药物（巯嘌呤[AZA]/ 硫鸟嘌呤）的炎症性肠病（IBD）成人患者，硫鸟嘌呤（TG）是一种安全的替代药物。然而，儿科 IBD 中相关数据较少。因此，我们旨在评估 TG 作为维持治疗的安全性。
在荷兰，对接受 TG 治疗的 IBD 儿童进行了一项回顾性、多中心队列研究。根据常见不良事件术语标准评估并列出了 TG 相关不良事件（AE）。
共有 6 家中心纳入了 36 名接受 TG（中位剂量 15mg/天）治疗的 IBD 儿童（中位年龄 14.5 岁）。5 例患者在随访期间出现 AE [胰腺炎（3 级）、肝毒性（3 级）（n=2）、艰难梭菌感染（2 级）和腹痛（2 级）]。所有（n=8）曾因 AZA 诱导胰腺炎而停药的患者在改用 TG 后未再发生胰腺炎。
在儿科 IBD 中，TG 似乎是 AZA 诱导胰腺炎时的一种安全替代药物。需要进一步研究以评估 TG 的长期安全性和疗效。
