Dosing 6-thioguanine in inflammatory bowel disease: expert-based guidelines for daily practice.

Abstract

Conventional thiopurines are considered to be effective and safe in the treatment of inflammatory bowel disease (IBD) patients; unfortunately more than 50% of patients discontinue thiopurine therapy, mainly due to the development of intractable adverse events. In recent years, the use of 6-thioguanine has been proposed as an alternative thiopurine in IBD patients failing to tolerate or to respond to conventional thiopurine therapy. In this clinical review, we describe the rationale for 6-thioguanine therapy and discuss the reported hepatotoxicity of 6-thioguanine (especially nodular regenerative hyperplasia). We propose expert-based guidelines for balanced treatment.

• Authors: Margien L Seinen, Dirk P van Asseldonk, Chris J J Mulder, Nanne K H de Boer
• Journal: Journal of gastrointestinal and liver diseases : JGLD (J Gastrointestin Liver Dis) Vol. 19 Issue 3 Pg. 291-4 (Sep 2010) ISSN: 1842-1121 [Electronic] Romania
• PMID: 20922194 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents
• Gastrointestinal Agents
• Thioguanine

Topics

• Anti-Inflammatory Agents (administration & dosage, adverse effects)
• Chemical and Drug Induced Liver Injury (etiology)
• Drug Monitoring
• Evidence-Based Medicine
• Gastrointestinal Agents (administration & dosage, adverse effects)
• Humans
• Inflammatory Bowel Diseases (drug therapy)
• Practice Guidelines as Topic
• Risk Assessment
• Thioguanine (administration & dosage, adverse effects)
• Treatment Outcome