Systematic Reviews
Copyright ©The Author(s) 2016.
World J Gastroenterol. Oct 28, 2016; 22(40): 9012-9021
Published online Oct 28, 2016. doi: 10.3748/wjg.v22.i40.9012
Table 1 Nodular regenerative hyperplasia of the liver during thioguanine therapy
Dosage of thioguanine6-TGN levelObserved NRHRef.
About 20 mg per day (18-24 mg)278 (68-492)0% (0/12)[20]
20 mg per day564 ± 2780% (0/28)[18]
20 mg per day802 (106-1092)0% (0/13)[47]
About 21 mg per day (0.3 mg/kg)464 (65-1199)6% (7/111)[48]
40 mg per day807 (105-2545)0% (0/11)[16]
About 40 mg per day (estimated)1230 (530-2310)62% (16/26)[15]
40-80 mg per dayUnknown36% (16/45)[45]
Table 2 Other adverse events associated with thioguanine use
Adverse eventPrevalenceRef.
GI complaints1%-17%[16,17,19,20,37,38]
Myelosuppression11%-15%[17,20,36,38]
General malaise4%-22%[17,38]
Allergic reaction1%-6%[17,33]
Other AE (e.g., myalgia, alopecia)1%-38%[16,17,19,20,33,36-38]
Table 3 Summary of included articles with most important study characteristics
AuthorRef.YearScore1Number of patientsNumber of IBD (CD/UC/IBDu)Dose (med)Follow-up (M)Effective n (%)Non-effective n (%)Discontinuation6-TGN (med)
n (%)
Dubinsky172001Very low1010/0/04047 (70)1 (10)2 (20)15482
Cheung182003Very low1513/1/140312 (79)1 (7)2 (14)N/A
Herrlinger192003Low3737/0/040621 (57)7 (19)9 (24)N/A
Bonaz212003Very low4949/0/0201238 (78)36 (12)5 (10)6484
Dubinsky222003Very low2114/7/020914 (67)3 (14)4 (19)13651
Teml232005Low200/14/620611 (55)3 (15)6 (30)8164
Qasim242007Very low4028/10/240619 (48)8 (20)13 (32)N/A
Ansari122008Low3030/0/040618 (60)5 (17)7 (23)8074
Almer252009Low2323/0/04095 (22)5 (22)13 (56)11552
Asseldonk162011Low460/46/0202237 (80)33 (7)6 (13)2784
Pavlidis152014Moderate6221/41/020646 (78)11 (14)5 (8)8114
Table 4 Summary of results of included articles in the total group, as well as different disease groups n (%)
Total number of patientsCDUCIBDuDaily dose (mg)1Treatment years2Benefit3No benefitDiscontinuation
353225 (64)119 (34)9 (2)20268228 (65)53 (15)72 (20)
[10-80]
DiscontinuationResponse unknown4
Crohn’s disease (n = 225)141118 (52)25 (11)40 (18)42 (19)
Ulcerative colitis (n = 119)12273 (62)16 (13)11 (9)19 (16)