Safety of Thioguanine in Pediatric Inflammatory Bowel Disease: A Multi-Center Case Series
Publication date
2022-12-01
Authors
Bayoumy, Ahmed B.
Jagt, Jasmijn Z.
Van Wering, Herbert M.
De Ridder, Lissy
Hummel, Thalia
Wolters, VM
Stapelbroek, Janneke
Benninga, Marc A.
Mulder, Chris J.J.
De Boer, Nanne K.H.
Editors
Advisors
Supervisors
Document Type
Article
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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.
Keywords
inflammatory bowel disease, pediatrics, thioguanine, thiopurines, Pediatrics, Perinatology, and Child Health, Gastroenterology
Citation
Bayoumy, A B, Jagt, J Z, Van Wering, H M, De Ridder, L, Hummel, T, Wolters, V M, Stapelbroek, J, Benninga, M A, Mulder, C J J, De Boer, N K H & De Meij, T G J 2022, 'Safety of Thioguanine in Pediatric Inflammatory Bowel Disease : A Multi-Center Case Series', Journal of Pediatric Gastroenterology and Nutrition, vol. 75, no. 6, pp. E111-E115. https://doi.org/10.1097/MPG.0000000000003621