OBJECTIVE: Approximately 10% of inflammatory bowel disease (IBD) patients receiving 6-mercaptopurine (6-MP) or azathioprine (AZA) develop drug hypersensitivity reactions necessitating early discontinuation of these traditional thiopurines. These allergic reactions typically reoccur upon rechallenge. Our recently published pilot study suggested that thioguanine (6-TG), a closely related thiopurine, was efficacious and well tolerated in IBD patients resistant to 6-MP/AZA. The aim of this study was to determine if hypersensitivity reactions to 6-MP/AZA reoccur with 6-TG therapy. METHODS: IBD patients allergic to 6-MP and/or AZA were treated with 6-TG as an alternate thiopurine. Hypersensitivity reactions to 6-MP/AZA must have been documented within 6 wk of 6-MP/AZA initiation. RESULTS: 6-TG was initiated in 21 IBD patients at a median (range) dose of 20 (10-40) mg/day. 6-TG hypersensitivity reaction occurred in only four of 21 (19%) patients after a median time interval of 9 days. Pancreatitis did not reoccur with 6-TG. Eighty-two percent of 6-TG tolerant patients were assessed as improved at last follow-up. CONCLUSIONS: These results suggest that 6-TG may be considered as a possible alternate thiopurine in patients allergic to traditional 6-MP/AZA. Despite these favorable results, candidates for 6-TG should be selected with caution, and its use should be reserved for IBD patients well informed about potential toxicities.
OBJECTIVE: Approximately 10% of inflammatory bowel disease (IBD) patients receiving 6-mercaptopurine (6-MP) or azathioprine (AZA) develop drug hypersensitivity reactions necessitating early discontinuation of these traditional thiopurines. These allergic reactions typically reoccur upon rechallenge. Our recently published pilot study suggested that thioguanine (6-TG), a closely related thiopurine, was efficacious and well tolerated in IBDpatients resistant to 6-MP/AZA. The aim of this study was to determine if hypersensitivity reactions to 6-MP/AZA reoccur with 6-TG therapy. METHODS:IBDpatients allergic to 6-MP and/or AZA were treated with 6-TG as an alternate thiopurine. Hypersensitivity reactions to 6-MP/AZA must have been documented within 6 wk of 6-MP/AZA initiation. RESULTS:6-TG was initiated in 21 IBDpatients at a median (range) dose of 20 (10-40) mg/day. 6-TGhypersensitivity reaction occurred in only four of 21 (19%) patients after a median time interval of 9 days. Pancreatitis did not reoccur with 6-TG. Eighty-two percent of 6-TG tolerant patients were assessed as improved at last follow-up. CONCLUSIONS: These results suggest that 6-TG may be considered as a possible alternate thiopurine in patients allergic to traditional 6-MP/AZA. Despite these favorable results, candidates for 6-TG should be selected with caution, and its use should be reserved for IBDpatients well informed about potential toxicities.
Authors: Christoph J Zech; Julia Seiderer; Walter Reinisch; Thomas Ochsenkuhn; Wolfgang Schima; Joachim Diebold; Fritz Wrba; Maximilian F Reiser; Stefan O Schoenberg Journal: Eur Radiol Date: 2007-01-13 Impact factor: 5.315
Authors: Alexander Teml; Matthias Schwab; Daan W Hommes; Sven Almer; Milan Lukas; Thomas Feichtenschlager; Timothy Florin; Julia Seiderer; Wolfgang Petritsch; Bernd Bokemeyer; Wolfgang Kreisel; Klaus R Herrlinger; Peter Knoflach; Bruno Bonaz; Thomas Klugmann; Hans Herfarth; Nikolaus Pedarnig; Walter Reinisch Journal: Wien Klin Wochenschr Date: 2007 Impact factor: 1.704
Authors: Emilio G Quetglas; Zlatan Mujagic; Simone Wigge; Daniel Keszthelyi; Sebastian Wachten; Ad Masclee; Walter Reinisch Journal: World J Gastroenterol Date: 2015-11-28 Impact factor: 5.742