Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2016; 22(40): 9012-9021
Published online Oct 28, 2016. doi: 10.3748/wjg.v22.i40.9012
Efficacy of thioguanine treatment in inflammatory bowel disease: A systematic review
Berrie Meijer, Chris JJ Mulder, Godefridus J Peters, Adriaan A van Bodegraven, Nanne KH de Boer
Berrie Meijer, Chris JJ Mulder, Adriaan A van Bodegraven and Nanne KH de Boer, Department of Gastroenterology and Hepatology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
Godefridus J Peters, Department of Medical Oncology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
Adriaan A van Bodegraven, Department of Gastroenterology, Geriatrics, Internal and Intensive Care Medicine (Co-MIK), Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, The Netherlands
Author contributions: Meijer B finished the manuscript; Meijer B and Peters GJ developed the figure; Meijer B, van Bodegraven AA and de Boer NKH conceived the study; Meijer B, van Bodegraven AA and de Boer NKH analyzed and interpreted the data; Meijer B and de Boer NKH collected all data; Meijer B and de Boer NKH drafted the manuscript; Mulder CJJ and Peters GJ revised the manuscript critically; de Boer NKH was the guarantor of the article; all authors commented on drafts of the paper; and approved the final draft of the article.
Conflict-of-interest statement: The Department of Gastroenterology and Hepatology of the VU University Medical Center received an unrestricted research grant by TEVA Pharma BV outside of this submitted work.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Berrie Meijer, MD, Department of Gastroenterology and Hepatology, VU University Medical Center, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands.
Telephone: +31-20-4440613 Fax: +31-20-4440554
Received: June 2, 2016
Peer-review started: June 3, 2016
First decision: July 12, 2016
Revised: July 20, 2016
Accepted: August 10, 2016
Article in press: August 10, 2016
Published online: October 28, 2016
Core Tip

Core tip: Whereas conventional thiopurines are globally accepted as second-line treatment of inflammatory bowel disease (IBD) patients, almost half of these patients discontinues this treatment due to ineffectiveness or intolerance. In this systematic review, the efficacy of thioguanine treatment, a thiopurine with a less extensive and complex metabolism, is systematically assessed to determine if this drug is an alternative in the treatment of IBD patients intolerant or ineffective to azathioprine and/or mercaptopurine. We showed that up to 65% of patients benefit of a switch to thioguanine, thus preserving these patients from potentially more harmful and expensive treatment with biologicals.