Safety of Thioguanine in Pediatric Inflammatory Bowel Disease: A Multi-Center Case Series. Issue 6 (20th September 2022)

• Record Type: Journal Article
• Authors: Bayoumy, Ahmed B.; Jagt, Jasmijn Z.; van Wering, Herbert M.; de Ridder, Lissy; Hummel, Thalia; Wolters, Victorien M.; Stapelbroek, Janneke; Benninga, Marc A.; Mulder, Chris J.J.; de Boer, Nanne K.H.; de Meij, Tim G.J.
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 75:Issue 6(2022)
• Page Start: e111
• Page End: e115
• Publication Date: 2022-09-20
• Subjects: inflammatory bowel disease -- pediatrics -- thioguanine -- thiopurines; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000003621
• Languages: English
• ISSNs: 0277-2116

Abstract

Abstract : Objectives: Thioguanine (TG) has been shown as a safe alternative in adults with inflammatory bowel disease (IBD) who did not tolerate conventional thiopurines [azathioprine (AZA)/mercaptopurine]. However, data in pediatric IBD are scarce. Therefore, we aimed to assess the safety of TG as maintenance therapy. Methods: A retrospective, multicenter cohort study of children with IBD on TG was performed in the Netherlands. TG-related adverse events (AE) were assessed and listed according to the common terminology criteria for AE. Results: Thirty-six children with IBD (median age 14.5 years) on TG (median dose 15 mg/day) were included in 6 centers. Five AE occurred during follow-up [pancreatitis (grade 3), hepatotoxicity (grade 3) (n = 2), Clostridium difficile infection (grade 2), and abdominal pain (grade 2)]. All patients (n = 8) with a previously AZA-induced pancreatitis did not redevelop pancreatitis on TG. Conclusions: In pediatric IBD, TG seems a safe alternative in case of AZA-induced pancreatitis. Further research assessing long-term TG-related safety and efficacy is needed.