Thiopurines and inflammatory bowel disease: Current evidence and a historical perspective

Jordan E. Axelrad, Abhik Roy, Garrett Lawlor, Burton Korelitz, Simon Lichtiger

Research output: Contribution to journalReview articlepeer-review

40 Scopus citations

Abstract

The use of thiopurines in inflammatory bowel disease (IBD) has been examined in numerous prospective, controlled trials, with a majority demonstrating a clinical benefit. We conducted this review to describe the historical and current evidence in the use of thiopurines in IBD. A systematic search was performed on MEDLINE between 1965 and 2016 to identify studies on thiopurines in IBD. The most robust evidence for thiopurines in IBD includes induction of remission in combination with anti-tumor necrosis factor (anti-TNF) agents, and maintenance of remission and postoperative maintenance in Crohn's disease. Less evidence exists for thiopurine monotherapy in induction of remission, maintenance of ulcerative colitis, chemoprevention of colorectal cancer, and in preventing immunogenicity to anti-TNF. Evidence was often limited by trial design. Overall, thiopurines have demonstrated efficacy in a broad range of presentations of IBD. With more efficacious novel therapeutic agents, the positioning of thiopurines in the management of IBD will change and future studies will analyze the benefit of thiopurines alone and in conjunction with these new medications.

Original languageEnglish
Pages (from-to)10103-10117
Number of pages15
JournalWorld Journal of Gastroenterology
Volume22
Issue number46
DOIs
StatePublished - 14 Dec 2016
Externally publishedYes

Keywords

  • Azathioprine
  • Crohn's disease
  • Inflammatory bowel disease
  • Mercaptopurine
  • Thiopurines
  • Ulcerative colitis

Fingerprint

Dive into the research topics of 'Thiopurines and inflammatory bowel disease: Current evidence and a historical perspective'. Together they form a unique fingerprint.

Cite this