Thiopurine Immunomodulators in Ulcerative Colitis: Moving Forward with Current Evidence

Title: Thiopurine Immunomodulators in Ulcerative Colitis: Moving Forward with Current Evidence

Volume: 12 Issue: 10

Author(s): Richard J. La Nauze and Miles P. Sparrow

Affiliation:

Keywords: Azathioporine, 6-mercaptopurine, thiopurines, immunomodulators, inflammatory bowel disease, ulcerative colitis, Crohn's disease, Colonoscopy, AZA, Nodular regenerative hyperplasia

Abstract: The goals of treatment for ulcerative colitis (UC) are to induce and maintain corticosteroid-free remission, thereby reducing hospitalizations and surgeries and preventing longer-term disease complications including colorectal cancer. Despite an incomplete evidence base, thiopurine immunomodulators remain a principle therapeutic option for patients failing aminosalicylate monotherapy and requiring multiple courses of corticosteroids. In this review, we outline the current evidence supporting the role of thiopurines in achieving these treatment goals in UC, including discussions of the important safety issues regarding their use. We also explore some of the recent evidence emerging in regards to the risks of lymphoproliferative disease, dosage optimization strategies and the role of thiopurines in achieving mucosal healing in UC and ultimately changing natural history outcomes for our patients.

Cite this article as:

J. La Nauze Richard and P. Sparrow Miles, Thiopurine Immunomodulators in Ulcerative Colitis: Moving Forward with Current Evidence, Current Drug Targets 2011; 12 (10) . https://dx.doi.org/10.2174/138945011796818180