Low Dose Azathioprine with Allopurinol in IBD: Early Days to Call It a Recipe for Success

Excerpt

Thiopurines (azathioprine [AZA] and 6-mercaptopurine [6-MP]) are one of the main therapies for the management of inflammatory bowel disease (IBD), commonly being used as steroid-sparing agents for the maintenance of remission [1]. Advances in pharmacogenomics and therapeutic monitoring have improved the accuracy and aggressiveness of the dosing of immunomodulators. However, thiopurines lead to adverse effects in one-third of patients, and many patients do not respond to an adequate dose and duration of therapy [2]. Hence, there is a need to optimize thiopurine pharmacotherapy to improve the efficacy while reducing the rate of adverse events. Combining low-dose thiopurine with allopurinol is one such optimization strategy for patients with IBD. However, only a few studies have reported the clinical benefit of using a combination of low-dose azathioprine with allopurinol (LDAA). …