Is thioguanine-associated sinusoidal obstruction syndrome avoidable? Lessons learned from 6-thioguanine treatment of inflammatory bowel disease and a mouse model

van Asseldonk, Dirk P., Oancea, Iulia, Jharap, Bindia, Duley, John A. and Florin, Timothy H. J. (2012) Is thioguanine-associated sinusoidal obstruction syndrome avoidable? Lessons learned from 6-thioguanine treatment of inflammatory bowel disease and a mouse model. Revista da Associação Médica Brasileira, 58 Supp. 1: S8-S13.

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Author van Asseldonk, Dirk P.
Oancea, Iulia
Jharap, Bindia
Duley, John A.
Florin, Timothy H. J.
Title Is thioguanine-associated sinusoidal obstruction syndrome avoidable? Lessons learned from 6-thioguanine treatment of inflammatory bowel disease and a mouse model
Translated title A tioguanina está associada à síndrome da obstrução sinusoidal evitável? Lições aprendidas com a 6-tioguanina no tratamento da doença inflamatória intestinal em modelo de ratos
Language of Title eng
Journal name Revista da Associação Médica Brasileira
Translated journal name Journal of the Brazilian Medical Association
Language of Journal Name por
Publication date 2012-03
Sub-type Article
Volume number 58
Issue number Supp. 1
ISSN 0104-4230; 1806-9282
Start page S8
End page S13
Total pages 7
Place of publication Bela Vista, Sao Paulo, Brazil
Publisher Associacao Medica Brasileira
Collection year 2013
Language eng
por
Formatted abstract 6-thioguanine (6TG) has become the ‘ugly sister’ of azathioprine and 6-mercaptopurine since it has been associated with sinusoidal obstruction syndrome (SOS) of the liver. Although the overall toxicity profile of 6TG seems superior to that of the other thiopurines, further use of 6TG was largely discarded due to fear of this complication and related hepatic nodular regenerative hyperplasia and veno-occlusive disease. There is emerging evidence showing that 6TG-associated SOS is a dose-dependent and reversible phenomenon. Therefore, it is urged that the use of 6TG in inflammatory bowel disease be reconsidered; randomized controlled studies are warranted.

A 6-tioguanina (6TG) tornou-se “a irmã feia” da azatioprina e da 6-mercaptopurina, pois tem sido associada à “síndrome da obstrução sinusoidal” (SOS) do fígado. Embora o perfil de toxicidade geral da 6TG talvez seja superior ao de outras tiopurinas, a continuação do uso de 6TG foi amplamente descartada devido ao medo dessa complicação e das relacionadas à hiperplasia hepática nodular regenerativa e doença veno-oclusiva. Evidências emergentes demonstram que a SOS associada à 6TG é um fenômeno dose-dependente que pode ser revertido. Portanto, é urgente que o uso do 6TG na doença inflamatória intestinal seja reconsiderado; são necessários estudos randomizados e controlados.
Keyword 6-Thioguanine
Sinusoidal obstruction syndrome
Veno-occlusive disease
Nodular regenerative hyperplasia
Leukemia
Inflammatory bowel disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Title and abstract only in Portuguese. Published under "Artigo Original" [Original Article]. This paper was presented in part to the III International Thiopurine Symposium, held at the Instituto de Educação e Ciências, Hospital Alemão Oswaldo Cruz, São Paulo, September 30th – October 2nd, 2010.

 
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Created: Fri, 20 Apr 2012, 17:24:06 EST by Dr John Duley on behalf of School of Pharmacy