Use of thiopurines in inflammatory bowel disease

Table 1 Indications for thiopurines in inflammatory bowel disease

	Indication	No indication
Crohn’s disease	Maintaining remission in moderate (to severe) CD (any site of disease especially for extensive disease); Maintaining remission in CD with early relapse (< 3 mo after the last flare) or frequent flares (more than two per year); Fistulizing CD (in combination with antibiotics, if no early start of anti-TNF or surgery necessary); Postoperative prevention of CD recurrence (unless high-risk situation such as repeated surgery or current smoker); In combination with anti-TNFs in case of severe CD (rapid step-up or top-down)	Induction of remission (as a sole therapy in active disease)
Ulcerative colitis (treated with 5-ASA at optimal dose unless intolerant)	Maintaining remission in steroid-dependent UC; Maintaining remission in UC with early relapse requiring steroids; Maintaining remission in UC with frequent flares requiring steroids; Maintaining remission in UC after induction of remission by ciclosporin, tacrolimus, or i.v. steroids; Acute or chronic refractory pouchitis	Induction of remission (as a sole therapy in active disease)

CD: Crohn’s disease; UC: Ulcerative colitis; TNF: Tumour necrosis factor; 5-ASA: 5-aminosalicylic acid.