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Colorectal
Review
A practical guide to thiopurine prescribing and monitoring in IBD
  1. Ben Warner1,
  2. Emma Johnston2,
  3. Monica Arenas-Hernandez3,
  4. Anthony Marinaki3,
  5. Peter Irving2,
  6. Jeremy Sanderson2
  1. 1 1st Floor College House, St Thomas’ Hospital, London, UK
  2. 2 Department of Gastroenterology, Guy's and St Thomas’ NHS Foundation Trust, London, UK
  3. 3 Purine Laboratory, Viapath, St Thomas’ Hospital, London, UK
  1. Correspondence to Dr Ben Warner, 1st Floor College House, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK; B.warner{at}uclmail.net

Abstract

Thiopurines are often the mainstay of treatment for many patients with inflammatory bowel disease. As such, a general understanding of the evidence behind their use and of their metabolism is extremely useful in clinical practice. This review gives a practical overview of thiopurine metabolism, the importance of thiopurine S-methyltransferase testing prior to the start of therapy and the monitoring of thioguanine nucleotide levels while on treatment, guiding a personalised approach to optimising thiopurine therapy.

  • AZATHIOPRINE
  • 6-MERCAPTOPURINE
  • INFLAMMATORY BOWEL DISEASE
  • THIOPURINE METHYLTRANSFERASE
  • ADVERSE DRUG REACTIONS

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/flgastro-2016-100738

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