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Monitoring thiopurine metabolites in inflammatory bowel disease
  1. Yago González-Lama1,
  2. Javier P Gisbert2
  1. 1Gastroenterology and Hepatology Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
  2. 2Gastroenterology Unit, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Madrid, Spain
  1. Correspondence to Dr Javier P Gisbert, Playa de Mojácar 29, Urb. Bonanza, Boadilla del Monte, Madrid 28669, Spain; javier.p.gisbert{at}


Thiopurines (azathioprine and mercaptopurine) are one of the immunosuppressive mainstays for the treatment of inflammatory bowel disease. In spite of its widespread use, thiopurine metabolism is still not fully understood, and a significant proportion of patients suffer toxicity or lack of efficacy. Different enzymatic pathways with individual variations constitute a pharmacogenetic model that seems to be suitable for monitoring and therapeutic intervention. This review is focused on current concepts and recent research that may help clinicians to rationally optimise thiopurine treatment in patients with inflammatory bowel disease.


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