February 06, 2012

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The Safety of Thiopurines: New Data, New Decisions

Laurent Beaugerie, MD, Harry Sokol, MD, Philippe Seksik, MD, and Jacques Cosnes, MD

Thiopurines are widely used, for prolonged periods, as maintenance treatment in Crohn’s disease and ulcerative colitis. Some safety concerns including blood toxicity, immunoallergic reactions, and teratogenicity have been recognized since the early development of these drugs. These established safety issues are updated in the present review. New risks including liver toxicity, opportunistic infections, and non-melanoma skin cancers have more recently been identified and quantified through post-marketing observational studies. These are also detailed here, along with their consequences in clinical practice. Inflamm Bowel Dis Monit 2010;10(4):117–25.

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LATEST ARTICLES

Leading Articles
- Cytokine Regulation of Gut Inflammation in IBD
  
  Thomas T MacDonald, PhD, FRCPath, FMedSci¹, Iona Bell, MD¹, and Giovanni Monteleone, MD²
  
  ¹Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK, and ²Dipartimento di Medicina Interna e Centro di Eccellenza per lo Studio delle Malattie Complesse e Multifattoriali, Università Tor Vergata, Rome, Italy
  
  Anti-cytokine therapies, such as the three licensed anti-tumor necrosis factor-α (anti-TNF-α) antibodies, have transformed the management of difficult-to-treat IBD patients. However, only 40–50% of patients respond to these agents, there are side effects, and efficacy wanes with time.
- The Safety of Thiopurines: New Data, New Decisions
  
  Laurent Beaugerie, MD, Harry Sokol, MD, Philippe Seksik, MD, and Jacques Cosnes, MD
  
  Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine, and UPMC–Paris Universitas, Paris, France
  
  Thiopurines are widely used, for prolonged periods, as maintenance treatment in Crohn’s disease and ulcerative colitis. Some safety concerns including blood toxicity, immunoallergic reactions, and teratogenicity have been recognized since the early development of these drugs. These established safety issues are updated in the present review.
- Risks of Radiation Injury in IBD Patients
  
  Adam B Kaufman, MD, and David T Rubin, MD
  
  Inflammatory Bowel Disease Center, Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago, Chicago, IL, USA
  
  IBD is a chronic and recurring disease involving the gastrointestinal tract with associated potential complications and extra-intestinal manifestations. Patients often require extensive and repetitive diagnostic medical imaging procedures to evaluate the extent of the disease and possible complications over long periods of time.
Clinical Reviews
Meeting Reports
- Report from the 5th Congress  of the European Crohn’s and  Colitis Organisation
  
  Xavier Treton, MD¹, and Laurent Peyrin-Biroulet, MD, PhD²
  
  Prague, Czech Republic, February 25–27, 2010
  ¹INSERM, U773, Paris, University of Paris 7; and Gastroenterology Department, Beaujon Hospital, Clichy; ²INSERM, U954, and Department of Hepatogastroenterology, University Hospital of Nancy, Nancy, France
  
  The 5th European Crohn’s and Colitis Organisation (ECCO) Congress was held in Prague, Czech Republic, from February 25–27, 2010. Its success continues unabated with >2500 gastroenterologists gathering for this key annual event. A selection of original basic and clinical communications is reported herein.
- Report from the British Society  of Gastroenterology (BSG)  Annual Meeting 2010
  
  Vikki Garrick, BSc, and Richard K Russell, PhD
  
  Liverpool, UK, March 22–26, 2010
  Department of Paediatric Gastroenterology, Yorkhill Children’s Hospital, Glasgow, UK
  
  This year, the Annual Meeting of the British Society of Gastroenterology (BSG) was held in Liverpool for the first time. The venue for the meeting was the Echo Arena/BT conference centre in the Docklands area of the city, with a meeting program that, in addition to IBD presentations, boasted several presentations by Nobel Prize winners. This report focuses on the key IBD-related presentations at the meeting.

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