Safety of Thiopurine Use in Paediatric Gastrointestinal Disease
Corresponding Author
Erasmo Miele
Department of Translational Medical Science, Section of Paediatrics, University of Naples “Federico II”, Italy
Address correspondence and reprint requests to Erasmo Miele, MD, PhD, Department of Translational Medical Science, Section of Paediatrics, University of Naples “Federico II”, Via S. Pansini, 5, 80127 Naples Italy (e-mail: [email protected]); Nikhil Thapar, BMFRCPCH PhD, Queensl and Children's Hospital, Stanley St, Brisbane QLD 4101, Australia (e-mail: [email protected]).Search for more papers by this authorMarc A. Benninga
Department of Paediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital/Amsterdam UMC, Amsterdam, The Netherlands
Search for more papers by this authorIlse Broekaert
Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, University of Cologne, Cologne, Germany
Search for more papers by this authorJernej Dolinsek
Department of Pediatrics, Gastroenterology Unit, University Medical Centre Maribor, Maribor, Slovenia
Department of Paediatrics, Medical Faculty of University of Maribor, Maribor, Slovenia
Search for more papers by this authorEmmanuel Mas
IRSD, Université de Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France
Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
Search for more papers by this authorRok Orel
Department of Gastroenterology, Hepatology and Nutrition, Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
Search for more papers by this authorCorina Pienar
Paediatrics Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
Search for more papers by this authorCarmen Ribes-Koninckx
Pediatric Gastroenterolgy, Hepatology and Nutrition, La Fe University Hospital, Valencia, Spain
Search for more papers by this authorRut A. Thomassen
Pediatric Nutrition and Dietetics Unit, Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Search for more papers by this authorMike Thomson
Department of Paediatric Gastroenterology, Sheffield Children's NHS Foundation Trust, Sheffield
Search for more papers by this authorChristos Tzivinikos
Department of Paediatric Gastroenterology, Hepatology and Nutrition, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
Search for more papers by this authorCorresponding Author
Nikhil Thapar
Neurogastroenterology and Motility Unit, UCL Great Ormond Street Institute for Child Health and Great Ormond Street Hospital, London, United Kingdom
Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia
Address correspondence and reprint requests to Erasmo Miele, MD, PhD, Department of Translational Medical Science, Section of Paediatrics, University of Naples “Federico II”, Via S. Pansini, 5, 80127 Naples Italy (e-mail: [email protected]); Nikhil Thapar, BMFRCPCH PhD, Queensl and Children's Hospital, Stanley St, Brisbane QLD 4101, Australia (e-mail: [email protected]).Search for more papers by this authorCorresponding Author
Erasmo Miele
Department of Translational Medical Science, Section of Paediatrics, University of Naples “Federico II”, Italy
Address correspondence and reprint requests to Erasmo Miele, MD, PhD, Department of Translational Medical Science, Section of Paediatrics, University of Naples “Federico II”, Via S. Pansini, 5, 80127 Naples Italy (e-mail: [email protected]); Nikhil Thapar, BMFRCPCH PhD, Queensl and Children's Hospital, Stanley St, Brisbane QLD 4101, Australia (e-mail: [email protected]).Search for more papers by this authorMarc A. Benninga
Department of Paediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital/Amsterdam UMC, Amsterdam, The Netherlands
Search for more papers by this authorIlse Broekaert
Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, University of Cologne, Cologne, Germany
Search for more papers by this authorJernej Dolinsek
Department of Pediatrics, Gastroenterology Unit, University Medical Centre Maribor, Maribor, Slovenia
Department of Paediatrics, Medical Faculty of University of Maribor, Maribor, Slovenia
Search for more papers by this authorEmmanuel Mas
IRSD, Université de Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France
Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
Search for more papers by this authorRok Orel
Department of Gastroenterology, Hepatology and Nutrition, Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
Search for more papers by this authorCorina Pienar
Paediatrics Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
Search for more papers by this authorCarmen Ribes-Koninckx
Pediatric Gastroenterolgy, Hepatology and Nutrition, La Fe University Hospital, Valencia, Spain
Search for more papers by this authorRut A. Thomassen
Pediatric Nutrition and Dietetics Unit, Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
Search for more papers by this authorMike Thomson
Department of Paediatric Gastroenterology, Sheffield Children's NHS Foundation Trust, Sheffield
Search for more papers by this authorChristos Tzivinikos
Department of Paediatric Gastroenterology, Hepatology and Nutrition, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
Search for more papers by this authorCorresponding Author
Nikhil Thapar
Neurogastroenterology and Motility Unit, UCL Great Ormond Street Institute for Child Health and Great Ormond Street Hospital, London, United Kingdom
Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia
Address correspondence and reprint requests to Erasmo Miele, MD, PhD, Department of Translational Medical Science, Section of Paediatrics, University of Naples “Federico II”, Via S. Pansini, 5, 80127 Naples Italy (e-mail: [email protected]); Nikhil Thapar, BMFRCPCH PhD, Queensl and Children's Hospital, Stanley St, Brisbane QLD 4101, Australia (e-mail: [email protected]).Search for more papers by this authorThe authors report no conflicts of interest.
ABSTRACT
Thiopurines, alone or in combination with other agents, have a pivotal role in the treatment of specific gastrointestinal and hepatological disorders. In inflammatory bowel disease and autoimmune hepatitis thiopurines have proven their value as steroid sparing agents for the maintenance of remission and may be considered for preventing postoperative Crohn disease recurrence where there is moderate risk of this occurring. Their use with infliximab therapy reduces antibody formation and increases biologic drug levels. The routine clinical use of thiopurines has, however, been questioned due to a number of potential adverse effects. The aim of this article is to provide information regarding the use, and in particular, safety of these agents in clinical practice in the light of such potentially severe, albeit rare, effects.
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