ArticleJournal of Crohn's & colitis2010
Combination of thiopurines and allopurinol: adverse events and clinical benefit in IBD.
Article in Journal of Crohn's & colitis, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 75 citations in OpenAlex.
- Randomised clinical trial: individualised vs. weight-based dosing of azathioprine in Crohn's disease.Alimentary pharmacology & therapeutics · 2014Trial
- Low allopurinol doses are sufficient to optimize azathioprine therapy in inflammatory bowel disease patients with inadequate thiopurine metabolite concentrations.European journal of clinical pharmacology · 2013Trial
- Prescribing Inflammatory Bowel Disease Medications in Chronic Kidney Disease: A Practical Guide.Alimentary pharmacology & therapeutics · 2025Review
- OralPharmaceutics · 2022Article
- Review
- Immunogenicity of BNT162b2 Vaccine Booster Dose in Patients With Inflammatory Bowel Disease Receiving Infliximab Combination Therapy: A Prospective Observational Study.Frontiers in medicine · 2022Article
- Short-Chain Naphthoquinone Protects Against Both Acute and Spontaneous Chronic Murine Colitis by Alleviating Inflammatory Responses.Frontiers in pharmacology · 2021Article
- Idebenone Protects against Spontaneous Chronic Murine Colitis by Alleviating Endoplasmic Reticulum Stress and Inflammatory Response.Biomedicines · 2020Article
- Are Patients with Inflammatory Bowel Disease at Increased Risk for Covid-19 Infection?Journal of Crohn's & colitis · 2020Article
- Idebenone Protects against Acute Murine Colitis via Antioxidant and Anti-Inflammatory Mechanisms.International journal of molecular sciences · 2020Article
- Thiopurines with low-dose allopurinol (ThiLDA)-a prospective clinical one-way crossover trial.European journal of clinical pharmacology · 2019Article
- A Comprehensive Review of the Diagnosis and Pharmacological Management of Crohn's Disease in the Elderly Population.Drugs & aging · 2019Review
- Review
- Revisiting the Role of Thiopurines in Inflammatory Bowel Disease Through Pharmacogenomics and Use of Novel Methods for Therapeutic Drug Monitoring.Frontiers in pharmacology · 2018Review
- Optimizing Thiopurine Therapy in Inflammatory Bowel Disease Among 2 Real-life Intercept Cohorts: Effect of Allopurinol Comedication?Inflammatory bowel diseases · 2017Article
- A member of the gut mycobiota modulates host purine metabolism exacerbating colitis in mice.Science translational medicine · 2017Article
- Neutropenia in the Elderly: A Rheumatology Perspective.Drugs & aging · 2016Review
- Pharmacology and Optimization of Thiopurines and Methotrexate in Inflammatory Bowel Disease.Clinical pharmacokinetics · 2016Review
- Elderly patients and inflammatory bowel disease.World journal of gastrointestinal pharmacology and therapeutics · 2016Review
- The Impact of Azathioprine-Associated Lymphopenia on the Onset of Opportunistic Infections in Patients with Inflammatory Bowel Disease.PloS one · 2016Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
aimsAllopurinol has been presented as a safe and effective adjunct to thiopurine therapy in inflammatory bowel disease (IBD). We aimed to determine the rate of infectious complications and clinical successes with a combination of thiopurine/allopurinol in IBD, and to identify which variables predict 6-thioguanine, 6-methylmercaptopurine, and white blood cell levels. Additionally we aimed to identify which variables predict complications.
methodsA retrospective database search identified patients with inflammatory bowel disease on both thiopurines and allopurinol. Regression modeling was used to identify which variables predicted metabolite levels, white blood cell levels, and complications.
resultsTwenty-seven subjects were found, with 20 treated intentionally and 7 inadvertently after a concurrent gout diagnosis. Thirteen of 20 patients had a major clinical improvement and 7 of 16 stopped steroids. Five infectious complications occurred. These included 2 cases of shingles, and one each of PCP, EBV, and viral meningitis. Significant predictors of metabolite levels included the dose of thiopurine and allopurinol, age, and BMI. Low white blood cell count levels were associated with increased doses, high BMI, and older age. Despite having only 5 events, there was a difference in absolute lymphocyte count between patients with and without infection (median 200 per mm³ vs 850 per mm³ respectively, p=0.0503).
conclusionsAdjunctive allopurinol therapy in shunting patients produced major clinical improvement in 48% of patients. However, a surprising number of opportunistic infections have occurred. Low absolute lymphocyte count may be a previously unrecognized indicator of risk of opportunistic infections.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.