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Updated: May 13, 2026

In Vivo Augmentation of Gut-Homing Regulatory T Cell Induction
Published on: January 22, 2020
Use of thiopurines in inflammatory bowel disease
Pascal Frei1, Luc Biedermann, Ole Haagen Nielsen
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital of Zürich, CH-8091 Zürich, Switzerland.
Abstract:
The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, including the combination of azathioprine and allopurinol, switching of thiopurine therapy in case of side effects, the use of azathioprine in pregnancy, the infection risk using thiopurines and the evidence when to stop thiopurines. Excellent reviews have been published on the thiopurine metabolic pathway which will not be discussed here in detail.
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