Review
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World J Gastroenterol. Mar 21, 2013; 19(11): 1699-1706
Published online Mar 21, 2013. doi: 10.3748/wjg.v19.i11.1699
Thiopurines in inflammatory bowel disease revisited
Florian Bär, Christian Sina, Klaus Fellermann
Florian Bär, Christian Sina, Klaus Fellermann, Medical Department 1, University Hospital Schleswig Holstein, 23538 Lübeck, Germany
Author contributions: All authors contributed equally to the conception, design and drafting of the article; they revised it critically and gave their final approval of the version to be published.
Correspondence to: Klaus Fellermann, MD, Medical Department 1, University Hospital Schleswig Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany. klaus.fellermann@uk-sh.de
Telephone: +49-451-5002398 Fax: +49-451-5006242
Received: August 21, 2012
Revised: November 9, 2012
Accepted: November 14, 2012
Published online: March 21, 2013
Processing time: 212 Days and 16.6 Hours
Abstract

Although a great variety of new drugs have been introduced for the therapy of inflammatory bowel diseases so far, a definite cure of the disease is still out of scope. An anti-inflammatory approach to induce remission followed by maintenance therapy with immunosupressants is still the mainstay of therapy. Thiopurines comprising azathioprine and its active metabolite mercaptopurine as well as tioguanine, are widely used in the therapy of chronic active inflammatory bowel disease (IBD). Their steroid sparing potential and efficacy in remission maintenance are out of doubt. Unfortunately, untoward adverse events are frequently observed and may preclude further administration or be life threatening. This review will focus on new aspects of thiopurine therapy in IBD, its efficacy and safety.

Keywords: Thiopurines; Mercaptopurine; Tioguanine; Azathioprine; Ulcerative colitis; Crohn’s disease