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Multicenter Study
. 2022 Dec 1;75(6):e111-e115.
doi: 10.1097/MPG.0000000000003621. Epub 2022 Sep 20.

Safety of Thioguanine in Pediatric Inflammatory Bowel Disease: A Multi-Center Case Series

Ahmed B Bayoumy  1 , Jasmijn Z Jagt  2   3 , Herbert M van Wering  4 , Lissy de Ridder  5 , Thalia Hummel  6 , Victorien M Wolters  7 , Janneke Stapelbroek  8 , Marc A Benninga  9 , Chris J J Mulder  10 , Nanne K H de Boer  10 , Tim G J de Meij  2   9 ; Kids with Crohn’s, Colitis (KiCC) Working Group for Collaborative Paediatric IBD Research in the Netherlands
Affiliations
Multicenter Study

Safety of Thioguanine in Pediatric Inflammatory Bowel Disease: A Multi-Center Case Series

Ahmed B Bayoumy et al. J Pediatr Gastroenterol Nutr. .

Abstract

Objectives: Thioguanine (TG) has been shown as a safe alternative in adults with inflammatory bowel disease (IBD) who did not tolerate conventional thiopurines [azathioprine (AZA)/mercaptopurine]. However, data in pediatric IBD are scarce. Therefore, we aimed to assess the safety of TG as maintenance therapy.

Methods: A retrospective, multicenter cohort study of children with IBD on TG was performed in the Netherlands. TG-related adverse events (AE) were assessed and listed according to the common terminology criteria for AE.

Results: Thirty-six children with IBD (median age 14.5 years) on TG (median dose 15 mg/day) were included in 6 centers. Five AE occurred during follow-up [pancreatitis (grade 3), hepatotoxicity (grade 3) (n = 2), Clostridium difficile infection (grade 2), and abdominal pain (grade 2)]. All patients (n = 8) with a previously AZA-induced pancreatitis did not redevelop pancreatitis on TG.

Conclusions: In pediatric IBD, TG seems a safe alternative in case of AZA-induced pancreatitis. Further research assessing long-term TG-related safety and efficacy is needed.

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Conflict of interest statement

N.K.H.d.B has served as a speaker for AbbVie and MSD has served as consultant and/or principal investigator for TEVA Pharma BV and Takeda. He has received a (unrestricted) research grant from Dr Falk, TEVA Pharma BV, MLDS and Takeda. L.d.R. has been involved in industry sponsored studies, investigator initiated study and/or consultancy with AbbVie, Lilly, Takeda, Janssen and Pfizer and received research grants from ZonMw, ECCO, and Pfizer. All authors declare that they have seen and approved the final version of the manuscript. The remaining authors report no conflicts of interest.

Comment in

References

    1. Turner D, Ruemmele FM, Orlanski-Meyer E, et al. Management of paediatric ulcerative colitis, part 1: ambulatory care—an evidence-based guideline from European Crohn’s and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2018;67:257–91. - PubMed
    1. van Rheenen PF, Aloi M, Assa A, et al. The medical management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update. J Crohns Colitis. 2021;15:171–94. - PubMed
    1. Hyams JS, Dubinsky MC, Baldassano RN, et al. Infliximab is not associated with increased risk of malignancy or hemophagocytic lymphohistiocytosis in pediatric patients with inflammatory bowel disease. Gastroenterology. 2017;152:1901–14.e3. - PubMed
    1. Crouwel F, Buiter HJC, de Boer NK. The thiopurine tale: an unexpected journey. J Crohns Colitis. 2022;16:1177–83. - PubMed
    1. Bayoumy AB, Simsek M, Seinen ML, et al. The continuous rediscovery and the benefit-risk ratio of thioguanine, a comprehensive review. Expert Opin Drug Metab Toxicol. 2020;16:111–23. - PubMed

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