Abstract | BACKGROUND: AIM: METHODS: A follow-up study was performed to investigate the long-term efficacy and safety of and tolerance to tioguanine in chronic active Crohn's disease. Sixteen patients who had successfully received 6-tioguanine for remission induction were enrolled. The reasons for immunosuppressive therapy were steroid dependence (n = 10), steroid refractoriness (n = 6) and intolerance (n = 6) or refractoriness (n = 1) to azathioprine. After remission induction therapy for 6 months, patients were treated for another 6 months with a daily dose of 20-40 mg tioguanine. Primary outcomes were remission ( Crohn's disease activity index < 150) and complete steroid reduction in steroid-dependent patients at 12 months. Laboratory controls of white blood count and liver enzymes, as well as erythrocyte tioguanine nucleotide levels, were performed regularly. RESULTS: CONCLUSIONS: In responders to tioguanine, the drug appears to be very effective in maintaining remission of chronic active Crohn's disease. Unfortunately, long-term hepatotoxicity seems to be an unpredictable and potentially severe adverse drug reaction. Therefore, to date, tioguanine cannot be recommended for general use outside clinical trials.
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Authors | K R Herrlinger, P Deibert, M Schwab, W Kreisel, C Fischer, K Fellermann, E F Stange |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 17
Issue 12
Pg. 1459-64
(Jun 15 2003)
ISSN: 0269-2813 [Print] England |
PMID | 12823147
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Inflammatory Agents
- Antimetabolites, Antineoplastic
- Steroids
- Methyltransferases
- thiopurine methyltransferase
- Thioguanine
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Topics |
- Adult
- Anti-Inflammatory Agents
(therapeutic use)
- Antimetabolites, Antineoplastic
(therapeutic use)
- Chronic Disease
- Crohn Disease
(drug therapy)
- Erythrocytes
(enzymology)
- Female
- Follow-Up Studies
- Humans
- Male
- Methyltransferases
(metabolism)
- Middle Aged
- Phenotype
- Steroids
(therapeutic use)
- Thioguanine
(adverse effects, therapeutic use)
- Treatment Outcome
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