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Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases

Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) of unknown etiology, characterized by repeated relapse and remission. The efficacy of thiopurine in IBD was first reported in the late 1960s. Thiopurines are used to alleviate the symptoms of IBD, esp...

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Autores principales: Tominaga, Keiichi, Sugaya, Takeshi, Tanaka, Takanao, Kanazawa, Mimari, Iijima, Makoto, Irisawa, Atsushi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878672/
https://www.ncbi.nlm.nih.gov/pubmed/33584261
http://dx.doi.org/10.3389/fphar.2020.582291
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author Tominaga, Keiichi
Sugaya, Takeshi
Tanaka, Takanao
Kanazawa, Mimari
Iijima, Makoto
Irisawa, Atsushi
author_facet Tominaga, Keiichi
Sugaya, Takeshi
Tanaka, Takanao
Kanazawa, Mimari
Iijima, Makoto
Irisawa, Atsushi
author_sort Tominaga, Keiichi
collection PubMed
description Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) of unknown etiology, characterized by repeated relapse and remission. The efficacy of thiopurine in IBD was first reported in the late 1960s. Thiopurines are used to alleviate the symptoms of IBD, especially UC. These drugs have a steroid-sparing potential and are widely used for the purpose of maintaining long-term remission in steroid-dependent cases. Therefore, thiopurines tend to be used long-term, but adverse events that accompany long-term use, such as lymphoproliferative disorders, must be monitored with care. In contrast, thiopurine plays a critical role in controlling the immunogenicity of biologics. Furthermore, although thiopurine is an old drug, new findings, including the prediction of serious adverse events such as severe alopecia and acute advanced leukopenia, by nudix hydrolase 15 gene polymorphism analysis, as well as the possibility of appropriate drug monitoring by detailed analysis of 6-thioguanine nucleotides have been clarified. However, the consequences of thiopurine withdrawal have not been determined and further studies, including randomized controlled trials, are necessary to answer the clinical question regarding the scenarios in which thiopurine withdrawal is possible.
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spelling pubmed-78786722021-02-13 Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases Tominaga, Keiichi Sugaya, Takeshi Tanaka, Takanao Kanazawa, Mimari Iijima, Makoto Irisawa, Atsushi Front Pharmacol Pharmacology Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) of unknown etiology, characterized by repeated relapse and remission. The efficacy of thiopurine in IBD was first reported in the late 1960s. Thiopurines are used to alleviate the symptoms of IBD, especially UC. These drugs have a steroid-sparing potential and are widely used for the purpose of maintaining long-term remission in steroid-dependent cases. Therefore, thiopurines tend to be used long-term, but adverse events that accompany long-term use, such as lymphoproliferative disorders, must be monitored with care. In contrast, thiopurine plays a critical role in controlling the immunogenicity of biologics. Furthermore, although thiopurine is an old drug, new findings, including the prediction of serious adverse events such as severe alopecia and acute advanced leukopenia, by nudix hydrolase 15 gene polymorphism analysis, as well as the possibility of appropriate drug monitoring by detailed analysis of 6-thioguanine nucleotides have been clarified. However, the consequences of thiopurine withdrawal have not been determined and further studies, including randomized controlled trials, are necessary to answer the clinical question regarding the scenarios in which thiopurine withdrawal is possible. Frontiers Media S.A. 2021-01-29 /pmc/articles/PMC7878672/ /pubmed/33584261 http://dx.doi.org/10.3389/fphar.2020.582291 Text en Copyright © 2021 Tominaga, Sugaya, Tanaka, Kanazawa, Iijima and Irisawa. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (http://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Tominaga, Keiichi
Sugaya, Takeshi
Tanaka, Takanao
Kanazawa, Mimari
Iijima, Makoto
Irisawa, Atsushi
Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases
title Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases
title_full Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases
title_fullStr Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases
title_full_unstemmed Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases
title_short Thiopurines: Recent Topics and Their Role in the Treatment of Inflammatory Bowel Diseases
title_sort thiopurines: recent topics and their role in the treatment of inflammatory bowel diseases
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878672/
https://www.ncbi.nlm.nih.gov/pubmed/33584261
http://dx.doi.org/10.3389/fphar.2020.582291
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