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Use of thiopurines in inflammatory bowel disease: an update

Authors :
Arshdeep Singh
Ramit Mahajan
Saurabh Kedia
Amit Kumar Dutta
Abhinav Anand
Charles N. Bernstein
Devendra Desai
C. Ganesh Pai
Govind Makharia
Harsh Vardhan Tevethia
Joyce WY Mak
Kirandeep Kaur
Kiran Peddi
Mukesh Kumar Ranjan
Perttu Arkkila
Rakesh Kochhar
Rupa Banerjee
Saroj Kant Sinha
Siew Chien Ng
Stephen Hanauer
Suhang Verma
Usha Dutta
Vandana Midha
Varun Mehta
Vineet Ahuja
Ajit Sood
Source :
Intestinal Research, Vol 20, Iss 1, Pp 11-30 (2022)
Publication Year :
2022
Publisher :
Korean Association for the Study of Intestinal Diseases, 2022.

Abstract

Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.

Details

Language :
English
ISSN :
15989100 and 22881956
Volume :
20
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Intestinal Research
Publication Type :
Academic Journal
Accession number :
edsdoj.f04f8dea708e4ec083f15f7e68daba85
Document Type :
article
Full Text :
https://doi.org/10.5217/ir.2020.00155