The relevance of azathioprine and 6-mercaptopurine therapy in inflammatory bowel disease, Crohn's disease, and ulcerative colitis, has been challenged in recent publications. In this article, a panel of experts gives advice, based on the relevant literature, on indications and practical use of azathioprine/6-mercaptopurine, prevention, and management of drug adverse reactions and special situations such as vaccination, pregnancy, and lactation.
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http://dx.doi.org/10.1097/MIB.0000000000000923 | DOI Listing |
World J Gastroenterol
January 2025
Department of Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney 2139, New South Wales, Australia.
Background: Ulcerative colitis (UC) is a chronic inflammatory condition requiring continuous treatment and monitoring. There is limited pharmacokinetic data on vedolizumab during maintenance therapy and the effect of thiopurines on vedolizumab trough concentrations is unknown.
Aim: To investigate the exposure-response relationship of vedolizumab and the impact of thiopurine withdrawal in UC patients who have achieved sustained clinical and endoscopic remission during maintenance therapy.
Metabolites
December 2024
Department of Medicinal Chemistry, University of Washington, Seattle, WA 98195, USA.
Background: Thiopurine methyltransferase (TPMT) plays a crucial role in the detoxification of thiopurine drugs, including the antimetabolites azathioprine and 6-mercaptopurine (6-MP) used to treat autoimmune diseases and various cancers. These drugs interfere with DNA synthesis by inhibiting the production of purine-containing nucleotides, leading to the death of rapidly dividing cells. TPMT inactivates thiopurine drugs by methylating at the thiol group.
View Article and Find Full Text PDFPan Afr Med J
December 2024
Laboratoire de Biologie et Santé, Faculté des Sciences, Université Ibn-Tofail, Kenitra, Maroc.
Introduction: the purpose of our study is to evaluate the efficacy of azathioprine as first-line treatment in patients with relapsing-remitting multiple sclerosis (RRMS) or progressive multiple sclerosis (PMS), who were supposed to be treated with beta-interferons but, due to limited resources, received azathioprine instead.
Method: among the 31 patients, 17 had relapsing-remitting MS (RRMS), 11 had primary progressive MS (PPMS), and 3 had secondary progressive MS (SPMS). Patients received azathioprine orally at a dose of 3 mg/kg/day over 2 years.
BMC Pharmacol Toxicol
December 2024
Department of Gastroenterology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
Background: Cronkhite-Canada syndrome (CCS) is a rare non-hereditary chronic inflammatory disease characteristic of gastrointestinal polyps and ectodermal abnormalities. Corticosteroid therapy is the mainstay medication for CCS. Few studies indicated immunosuppressants might be the choices for patients with steroid refractory, steroid dependent or intolerant.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri, USA.
Behçet's disease is a clinical diagnosis with variable presentations. Liver involvement is rare in the absence of vascular complications. We describe a patient diagnosed with Hashimoto's thyroiditis and autoimmune hepatitis on azathioprine who developed extensive aphthous ulcers approximately 10 years later.
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