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©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 21, 2011; 17(39): 4372-4381
Published online Oct 21, 2011. doi: 10.3748/wjg.v17.i39.4372
Published online Oct 21, 2011. doi: 10.3748/wjg.v17.i39.4372
Current status of thiopurine analogues in the treatment in Crohn's disease
Peter Laszlo Lakatos, Lajos S Kiss, 1st Department of Medicine, Semmelweis University, H-1083 Budapest, Hungary
Author contributions: Lakatos PL and Kiss LS co-authored this paper.
Correspondence to: Dr. Peter Laszlo Lakatos, MD, PhD, 1st Department of Medicine, Semmelweis University, H-1083 Budapest, Koranyi S 2A, Hungary. kislakpet@bel1.sote.hu
Telephone: +36-20-9117727 Fax: +36-1-3130250
Received: March 22, 2011
Revised: June 21, 2011
Accepted: June 28, 2011
Published online: October 21, 2011
Revised: June 21, 2011
Accepted: June 28, 2011
Published online: October 21, 2011
Abstract
In the last decades, with the development of biological therapy, the treatment paradigms in patients with Crohn’s disease have continuously evolved. Several studies focusing on the optimal use of both traditional immunosuppressants and biological therapy have been published, investigating conventional, accelerated step-up and top-down approaches. In addition, much emphasis has been placed in recent years on the determination of important predictive factors that could enable early patient stratification, which would lead to a tailored management strategy. In this review, the authors try to highlight new evidence on the optimal timing, benefits, and risks of immunosuppressants alone, or in combination, in patients with Crohn’s disease.
Keywords: Crohn’s disease; Immunosuppressives; Azathioprine; Thiopurine methyltransferase; Biologicals