4.7 Review

Cytotoxicity of Thiopurine Drugs in Patients with Inflammatory Bowel Disease

Journal

TOXICS
Volume 10, Issue 4, Pages -

Publisher

MDPI
DOI: 10.3390/toxics10040151

Keywords

thiopurines; azathioprine; mercaptopurine; thioguanine; cytotoxicity; inflammatory bowel disease; Crohn's disease; ulcerative colitis; pharmacogenetics; therapeutic drug monitoring

Funding

  1. Polish National Science Centre [2016/23/D/NZ2/01620]
  2. START 2021 Program of the Foundation for Polish Science (FNP)

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The effectiveness of thiopurine drugs in inflammatory bowel disease (IBD) has been confirmed for more than 50 years. Despite controversies over their cytotoxic properties and adverse effects, thiopurines are still widely used for maintaining remission in Crohn's disease and ulcerative colitis. Further research is needed to explore the modulation of thiopurine action in combination therapy and their interaction with the gut microbiota.
The effectiveness of thiopurine drugs in inflammatory bowel disease (IBD) was confirmed more than a half-century ago. It was proven that these can be essential immunomodulatory medications. Since then, they have been used routinely to maintain remission of Crohn's disease (CD) and ulcerative colitis (UC). The cytotoxic properties of thiopurines and the numerous adverse effects of the treatment are controversial. However, the research subject of their pharmacology, therapy monitoring, and the search for predictive markers are still very relevant. In this article, we provide an overview of the current knowledge and findings in the field of thiopurines in IBD, focusing on the aspect of their cytotoxicity. Due to thiopurines' benefits in IBD therapy, it is expected that they will still constitute an essential part of the CD and UC treatment algorithm. More studies are still required on the modulation of the action of thiopurines in combination therapy and their interaction with the gut microbiota.

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