COMMENTARY
Inflammatory bowel disease
Risks and benefits of azathioprine therapy
1 The Wellcome Trust Centre for Human Genetics, Headington, Oxford, UK
2 Gastroenterology Unit, University of Oxford, Oxford, UK
Correspondence to:
Correspondence to:
Dr D P B McGovern
The Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Headington, Oxford OX3 7BN, UK; dermot@well.ox.ac.uk
The risk of lymphoma may be increased by about fourfold in patients with inflammatory bowel disease treated with thiopurines. The increased risk could be a result of the medications, the severity of the underlying disease, or a combination of the two
Keywords: inflammatory bowel disease; Crohn’s disease; ulcerative colitis; azathioprine; lymphoma
| The first 150 words of the full text of this article appear below. |
The benefits of the thiopurines, azathioprine (AZA), and 6-mercaptopurine (6-MP) in maintaining remission and corticosteroid sparing in inflammatory bowel disease (IBD) are beyond doubt. However, adverse events as well as benefits should always be considered when the effectiveness of any treatment is being evaluated. The "short term" side effects of thiopurines have been well documented and there have been a number of studies examining the role of thiopurine methyltransferase activity in predicting the risk of these side effects. In this issue of Gut, Kandiel and colleagues1 address the difficult issue of the long term risk of lymphoma associated with thiopurine therapy (see page 1121). Using the technique of meta-analysis of cohort studies, the authors concluded that there was about a fourfold increase in lymphoma in IBD patients treated with thiopurines. The headline from this study will cause alarm among patients and clinicians alike but,
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- Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6-mercaptopurine
- A Kandiel, A G Fraser, B I Korelitz, C Brensinger, and J D Lewis
Gut 2005 54: 1121-1125.[Abstract] [Full Text] [PDF]
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