Allopurinol–thiopurine combination therapy in inflammatory bowel disease. (October 2014)

• Record Type: Journal Article
• Authors: Seinen, Margien L; de Boer, Nanne KH; van Bodegraven, Adriaan A; Hanauer, Stephen B; Hoentjen, Frank
• Is Part Of: Clinical investigation. Volume 4:Number 10(2014)
• Page Start: 873
• Page End: 879
• Publication Date: 2014-10
• Subjects: allopurinol -- azathioprine -- inflammatory bowel disease -- mercaptopurine; Drugs -- Testing -- Periodicals; Drug development -- Periodicals; Clinical trials -- Periodicals; 615.580724
• DOI: 10.4155/cli.14.81
• Languages: English
• ISSNs: 2041-6806

Abstract

Combination therapy with allopurinol and low-dose thiopurine (azathioprine and mercaptopurine) has been described as an alternative immunosuppressive strategy in adult inflammatory bowel disease patients. Currently, this combination treatment is used in clinical practice to optimize ineffective or non-tolerated weight-based thiopurine monotherapy. In the setting of persistent disease or thiopurine intolerances in combination with an aberrant ('skewed') thiopurine metabolism (6-MMP/6-TGN ≥ 20) allopurinol–thiopurine combination therapy can be a safe and effective approach. Here we will discuss the efficacy and safety of allopurinol–thiopurine combination therapy in inflammatory bowel disease patients. Furthermore, we will review the mechanism of action, recommendations for the use of combination therapy in daily clinical practice and points of interest for future research.