Evolving Considerations for Thiopurine Therapy for Inflammatory Bowel Diseases—A Clinical Practice Update: Commentary

Stephen B. Hanauer, William J. Sandborn, Gary R. Lichtenstein*

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Thiopurines (azathioprine, mercaptopurine, thioguanine) and methotrexate are widely used in a variety of clinical management scenarios for ulcerative colitis and Crohn's disease. With the introduction of biologic therapies over the last 2 decades, controversies have emerged as to how these immunomodulators should be used in clinical practice, either alone as monotherapies or in combination with biologic therapies. Here, we provide a summary of evidence and our interpretations regarding how physicians can or should incorporate these agents into clinical practice. We have organized the review into sections regarding their utility as monotherapy or as combination therapy with biologics and safety considerations. Clinical pharmacologic considerations are important regarding both efficacy and safety.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalGastroenterology
Volume156
Issue number1
DOIs
StatePublished - Jan 2019

Keywords

  • Crohn's
  • Immunomodulators
  • Inflammatory Bowel Disease
  • Ulcerative Colitis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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