Thiopurines in inflammatory bowel disease revisited

World J Gastroenterol. 2013 Mar 21;19(11):1699-706. doi: 10.3748/wjg.v19.i11.1699.


Although a great variety of new drugs have been introduced for the therapy of inflammatory bowel diseases so far, a definite cure of the disease is still out of scope. An anti-inflammatory approach to induce remission followed by maintenance therapy with immunosupressants is still the mainstay of therapy. Thiopurines comprising azathioprine and its active metabolite mercaptopurine as well as tioguanine, are widely used in the therapy of chronic active inflammatory bowel disease (IBD). Their steroid sparing potential and efficacy in remission maintenance are out of doubt. Unfortunately, untoward adverse events are frequently observed and may preclude further administration or be life threatening. This review will focus on new aspects of thiopurine therapy in IBD, its efficacy and safety.

Keywords: Azathioprine; Crohn’s disease; Mercaptopurine; Thiopurines; Tioguanine; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / therapeutic use*
  • Azathioprine / therapeutic use
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / pathology
  • Crohn Disease / diagnosis
  • Crohn Disease / drug therapy*
  • Crohn Disease / pathology
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Mercaptopurine / therapeutic use
  • Patient Selection
  • Purines / adverse effects
  • Purines / therapeutic use*
  • Remission Induction
  • Risk Factors
  • Thioguanine / therapeutic use
  • Treatment Outcome
  • Wound Healing / drug effects


  • Anti-Infective Agents
  • Gastrointestinal Agents
  • Purines
  • Mercaptopurine
  • Thioguanine
  • Azathioprine