6-thioguanine: A new old drug to procure remission in inflammatory bowel disease

Cheung, T. K. and Florin, T. H. J. (2003) 6-thioguanine: A new old drug to procure remission in inflammatory bowel disease. Internal Medicine Journal, 33 1-2: 44-46. doi:10.1046/j.1445-5994.2003.00321.x


Author Cheung, T. K.
Florin, T. H. J.
Title 6-thioguanine: A new old drug to procure remission in inflammatory bowel disease
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
1445-5994
Publication date 2003-01
Sub-type Article (original research)
DOI 10.1046/j.1445-5994.2003.00321.x
Volume 33
Issue 1-2
Start page 44
End page 46
Total pages 3
Editor Edward Byrne
Place of publication Carlton, VIC, Australia
Publisher Wiley-Blackwell Publishing
Collection year 2003
Language eng
Subject C1
321006 Gastroenterology and Hepatology
730100 Clinical (Organs, Diseases and Abnormal Conditions)
1103 Clinical Sciences
Formatted abstract
The thiopurine analogues, azathioprine (AZA) and 6-mercaptopurine (6-MP), have become the standard immunomodulating therapies for retaining remission in inflammatory bowel diseases (IBD).

A significant proportion of patients fails to tolerate AZA or 6-MP as a result of side-effects.

6-thioguanine (6-TG) (Lanvis™, GlaxoSmithKline, UK), has been used in the treatment of leukaemia. However, with the advent of other pharmacological agents, it is now rarely used in treatment of haematological conditions. 6-TG is directly metabolized to the active metabolite 6-TGN, thus avoiding the formation of 6-MMPR. It has been shown in children with leukaemia that 6-TG is well tolerated, despite producing a higher level of 6-TGN than 6-MP.7

We briefly report our experience with oral 40 mg b.i.d 6-TG in 15 IBD patients.

For the sizeable portion of patients who do not tolerate or respond to 6-MP/AZA, 6-TG looks to be an exciting alternative. However, we do not have treatment data beyond 21 weeks, and therefore caution the use of 6-TG outside of specialist IBD practices. We believe that the data provide a cogent argument for a properly powered controlled trial to measure long-term clinical efficacy and safety of 6-TG in IBD.
Keyword Medicine, General & Internal
6-mercaptopurine Therapy
Crohns-disease
Pharmacogenomics
Azathioprine
Thioguanine
Toxicity
Q-Index Code C1
Additional Notes Published under "Brief Communication"

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 01:30:49 EST