ReviewJournal of clinical and experimental hepatology2017
Role of Allopurinol in Optimizing Thiopurine Therapy in Patients with Autoimmune Hepatitis: A Review.
Review in Journal of clinical and experimental hepatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Autoimmune hepatitis in children: Guidelines of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).Hepatology international · 2025Guideline
- British Society of Gastroenterology guidelines for diagnosis and management of autoimmune hepatitis.Gut · 2025Guideline
- Difficult to treat and refractory autoimmune hepatitis: Recent advances in pharmacological management.World journal of hepatology · 2025Review
- Does allopurinol enhance efficacy of acute lymphoblastic leukemia maintenance therapy?Haematologica · 2025Article
- Metabolomics in autoimmune hepatitis: progress and perspectives.Frontiers in medicine · 2025Review
- Advances in the Treatment of Autoimmune Hepatitis.Journal of clinical and translational hepatology · 2024Review
- Discovery of coumaric acid derivatives hinted by coastal marine source to seek for uric acid lowering agents.Journal of enzyme inhibition and medicinal chemistry · 2023Article
- Optimizing Thiopurine Therapy with a Xanthine Oxidase Inhibitor in Patients with Systemic Autoimmune Diseases: A Single-Centre Experience.The Canadian journal of hospital pharmacy · 2021Article
- Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta-analysis.Experimental and therapeutic medicine · 2018Article
- Synthesis and anticancer activity of multisubstituted purines and xanthines with one or two propynylthio and aminobutynylthio groups.Medicinal chemistry research : an international journal for rapid communications on design and mechanisms of action of biologically active agents · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Autoimmune hepatitis (AIH) is a chronic immune mediated liver disease characterized by elevated transaminases, hyper gammaglobulinemia, presence of autoantibodies and interface hepatitis in the absence of a known etiology of liver disease. Thiopurines (azathioprine [AZA]/6-mercaptopurine [6MP]) and steroids remain the first line of treatment of AIH in both children and adults. However, a small proportion of AIH patients are either non-responders or develop side effects with AZA. The metabolism of AZA is complex and mediated by multiple enzymes. After absorption and getting converted to 6MP, it is converted to 6-thiouric acid, 6-methyl mercaptopurine (6MMP) and 6-thioguanine (6TG) by different enzymes. Elevated 6MMP levels are associated with hepatotoxicity and also poor efficacy due to simultaneous lower levels of 6TG, which is the active drug metabolite related to both efficacy and myelosuppression. Allopurinol, a xanthine oxidase inhibitor shifts the metabolism of AZA away from 6MMP toward 6TG. This combination of allopurinol with reduced dose of AZA is an alternative to more expensive and toxic second line therapy to induce remission in patients with AIH. This article discusses the mechanism of action of allopurinol in inducing response to AZA, reviews the published literature on this combination therapy and gives guidelines on the use of allopurinol in patients with AIH.
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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.