1. Safety of Thiopurine Use in Paediatric Gastrointestinal Disease
- Author
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Jernej Dolinsek, Christos Tzivinikos, Rut Ann Thomassen, Erasmo Miele, Carmen Ribes-Koninckx, Nikhil Thapar, Rok Orel, Corina Pienar, Ilse Broekaert, Mike Thomson, Emmanuel Mas, Marc A. Benninga, 'Federico II' University of Naples Medical School, University of Amsterdam [Amsterdam] (UvA), University Hospital of Cologne [Cologne], University medical centre Maribor (UKC Maribor), Institut de Recherche en Santé Digestive (IRSD ), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Victor Babeş University of Medicine and Pharmacy (UMFT), Hospital Universitari i Politècnic La Fe, Oslo University Hospital [Oslo], NHS Foundation Trust [London], The Royal Marsden, Al Jalila Children's Specialty Hospital, University College of London [London] (UCL), Queensland Paediatric Infectious Diseases Laboratory [Australia], University of Queensland [Brisbane]-Children's Health Research Centre, Paediatric Gastroenterology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ARD - Amsterdam Reproduction and Development, Miele, E., Benninga, M. A., Broekaert, I., Dolinsek, J., Mas, E., Orel, R., Pienar, C., Ribes-Koninckx, C., Thomassen, R. A., Thomson, M., Tzivinikos, C., and Thapar, N.
- Subjects
Infliximab therapy ,medicine.medical_specialty ,Autoimmune hepatitis ,Inflammatory bowel disease ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Gastrointestinal Agents ,[SDV.SP.MED]Life Sciences [q-bio]/Pharmaceutical sciences/Medication ,Recurrence ,inflammatory bowel disease ,030225 pediatrics ,Steroid sparing ,medicine ,[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Humans ,Immunologic Factors ,6-mercaptopurine ,Adverse effect ,Intensive care medicine ,Child ,azathioprine ,Thiopurine methyltransferase ,biology ,autoimmune hepatitis ,Crohn disease ,business.industry ,Mercaptopurine ,thiopurines ,Gastroenterology ,medicine.disease ,Inflammatory Bowel Diseases ,3. Good health ,Gastrointestinal disease ,Pediatrics, Perinatology and Child Health ,biology.protein ,adverse effects ,030211 gastroenterology & hepatology ,business ,Immunosuppressive Agents ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Thiopurines, alone or in combination with other agents, have a pivotal role in the treatment of specific gastrointestinal and hepatological disorders. In inflammatory bowel disease and autoimmune hepatitis thiopurines have proven their value as steroid sparing agents for the maintenance of remission and may be considered for preventing postoperative Crohn disease recurrence where there is moderate risk of this occurring. Their use with infliximab therapy reduces antibody formation and increases biologic drug levels. The routine clinical use of thiopurines has, however, been questioned due to a number of potential adverse effects. The aim of this article is to provide information regarding the use, and in particular, safety of these agents in clinical practice in the light of such potentially severe, albeit rare, effects.
- Published
- 2020