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Letter
Role of thiopurines as disease-modifying agents in Crohn’s disease
  1. Jonathan Blackwell1,
  2. Sonia Saxena2,
  3. Richard C Pollok1
  1. 1 Department of Gastroenterology, St George’s NHS Foundation Trust, London, UK
  2. 2 Department of Primary Care and Public Health, Imperial College, London, UK
  1. Correspondence to Dr Jonathan Blackwell, Department of Gastroenterology, St George’s NHS Foundation Trust, St George’s Hospital, London, SW17 0QT, UK; jonnyblackwell{at}gmail.com

https://doi.org/10.1136/gutjnl-2017-315840

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    We agree with Danese et al 1 that prospective studies to evaluate the disease-modifying action of antitumour necrosis factor (anti-TNF) drugs are overdue. As a counterpoint to this informative review, we would like to highlight some additional evidence for the role of thiopurines as disease-modifying agents in Crohn’s disease. A cohort study by Magro et al 2 supports a role for thiopurines in delaying phenotype progression from an inflammatory (B1) to a stricturing/penetrating (B2/B3) disease (HR 0.15, 95% CI 0.11 to 0.19). A meta-analysis of 10 …

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    Footnotes

    • Contributors All authors contributed to the preparation of this letter.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.