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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Nov 6, 2016; 7(4): 524-530
Published online Nov 6, 2016. doi: 10.4292/wjgpt.v7.i4.524
How I treat my inflammatory bowel disease-patients with thiopurines?
Berrie Meijer, Chris JJ Mulder, Adriaan A van Bodegraven, Nanne K H de Boer
Berrie Meijer, Chris JJ Mulder, Nanne KH de Boer, Department of Gastroenterology and Hepatology, VU University Medical Center, 1007 MB, Amsterdam, The Netherlands
Adriaan A van Bodegraven, Department of Gastroenterology, Geriatrics, Internal and Intensive Care Medicine (Co-MIK), Zuyderland Medical Center, 6130 MB, Sittard-Geleen, The Netherlands
Author contributions: de Boer NKH was the guarantor of the article; Meijer B completed the first draft of the manuscript; Mulder CJJ, van Bodegraven AA and de Boer NKH critically revised the manuscript; Meijer B finalized the article.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is 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/
Correspondence to: Nanne KH de Boer, MD, PhD, Department of Gastroenterology and Hepatology, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. khn.deboer@vumc.nl
Telephone: +31-20-4440613 Fax: +31-20-4440554
Received: July 21, 2016
Peer-review started: July 21, 2016
First decision: September 5, 2016
Revised: September 12, 2016
Accepted: October 5, 2016
Article in press: October 7, 2016
Published online: November 6, 2016
Core Tip

Core tip: Conventional thiopurine therapy with azathioprine and mercaptopurine in inflammatory bowel disease is associated with several adverse events causing cessation of therapy in up to half of the patients. On the contrary, thiopurine therapy is often unnecessarily discontinued. In this practical review, we provide information on how thiopurine therapy is initiated and maintained using periodical laboratory tests and the application of various treatment strategies (including the administration of a third thiopurine; thioguanine), based on the experience in the two expert thiopurine centers in The Netherlands.