Azathioprine in the therapy of paediatric inflammatory bowel disease – part I: treatment indications, dosing and thiopurine-related adverse events

Česká verze

Authors: Pospíšilová K.; Bronský J.
Authors place of work: Oddělení dětské gastroenterologie, Pediatrická klinika 2. LF UK v Praze a FN v Motole, Praha
Published in the journal: Gastroent Hepatol 2021; 75(6): 500-507
Category: Dětská gastroenterologie a hepatologie: přehledová práce
doi: https://doi.org/10.48095/ccgh2021500

Summary

Background: Thiopurines (in Europe mainly azathioprine) are widely used in the treatment of inflammatory bowel diseases in children. Due to a prolonged time until the onset of therapeutic effect, those drugs are aimed to be used in the maintenance phase of the therapy rather than for induction of remission. Thiopurines are sometimes used in combination therapy (with aminosalicylates or biological treatment agents). The adverse events of these drugs occur as often as in 15–40% cases and may lead to treatment cessation in a significant number of patients. Aims: To overview available information on (mainly) children suffering from inflammatory bowel disease. Conclusion: Genetic examination accompanied with laboratory monitoring of blood count parameters (specifically at the beginning of therapy) and biochemistry can help prevent some of the severe adverse events.

Keywords:

paediatrics – Ulcerative colitis – Crohn’s disease – mercaptopurine – thiopurines

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