期刊
INTESTINAL RESEARCH
卷 20, 期 1, 页码 11-30出版社
KOREAN ASSOC STUDY INTESTINAL DISEASES
DOI: 10.5217/ir.2020.00155
关键词
Inflammatory bowel disease; Azathioprine; Mercaptopurine; 6-Thioguanine; Developing countries
资金
- Bingham Chair in Gastroenterology
- Janssen Canada
- Pfizer Canada
- Abbvie Canada
- Takeda Canada
- Medtronic Canada
- Abbvie
- Janssen
- Roche
- Hong Kong College of Physicians
- Ferring
- Menarini
- Pfizer
- Olympus
- Boehringer Ingelheim
- Takeda
Inflammatory bowel disease (IBD) is now a global disease, with treatment mainly involving biologics and thiopurines, although their use is limited in developing countries. Thiopurines are critical for IBD patients in these regions, but face restrictions in usage.
Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.
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