SynthesisFrontline gastroenterology2021
Pancreatitis associated with azathioprine and 6-mercaptopurine use in Crohn's disease: a systematic review.
Synthesis in Frontline gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
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
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between TPMT/NUDT15 and thiopurines.European journal of human genetics : EJHG · 2026Guideline
- Infliximab for maintenance of medically-induced remission in Crohn's disease.The Cochrane database of systematic reviews · 2024Pooled it
- Infliximab for medical induction of remission in Crohn's disease.The Cochrane database of systematic reviews · 2023Pooled it
- Vitamin D for the treatment of inflammatory bowel disease.The Cochrane database of systematic reviews · 2023Pooled it
- Clinical characteristics of acute pancreatitis in patients with inflammatory bowel disease: a nationwide survey in Japan.Journal of gastroenterology · 2026Article
- Comparison of Azathioprine-Induced Pancreatitis and Gastrointestinal Intolerance in IBD: Role of Demographics, Clinical Variables, and HLA DQA1/DRB1 Alleles.Journal of clinical medicine · 2025Article
- Acute necrotising pancreatitis in a patient with Behçet's disease.BMJ case reports · 2025Article
- RAB19, SERPINB9P1, and Pancreatitis in Patients Taking Azathioprine in Routine Clinical Practice: Genome and Transcriptome-Wide Association Studies.Clinical pharmacology and therapeutics · 2025Article
- Clinical Features of Thiopurine-Induced Acute Pancreatitis: Comparison Between Patients With and Without Inflammatory Bowel Disease.Crohn's & colitis 360 · 2025Article
- Azathioprine monotherapy withdrawal in inflammatory bowel diseases: A retrospective mono-centric study.World journal of gastroenterology · 2023Article
- Article
- Azathioprine-Induced Acute Pancreatitis in a Patient With Inflammatory Bowel Disease.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2023Article
- Severity of acute pancreatitis in patients with inflammatory bowel disease in the era of biologics: A propensity-score-matched analysis using a nationwide database in Japan.JGH open : an open access journal of gastroenterology and hepatology · 2023Article
- HLA variants associated with azathioprine-induced pancreatitis in patients with Crohn's disease.Clinical and translational science · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Thiopurines are proven agents in the treatment of Crohn's disease. While pancreatitis is recognised as an adverse event associated with therapy, the effect size and morbidity of thiopurine-induced pancreatitis is not known. The aim of this systematic review and meta-analysis was to quantify the risk of pancreatitis with azathioprine and 6-mercaptopurine (6-MP) within Crohn's disease. We searched six electronic databases from inception to 29 October 2019. The primary outcomes measures were the occurrence of pancreatitis. We calculated pooled OR with corresponding 95% CIs for risk of pancreatitis. A number needed to harm analysis was performed. The search identified 4418 studies, of which 25 randomised controlled trials met the criteria for inclusion. The number of patients treated with azathioprine to cause an episode of pancreatitis was 36 (induction of remission) and 31 (maintenance of remission). The risk of pancreatitis in patients receiving azathioprine across all contexts was 3.80%, compared with a control risk of 0.2% (placebo) and 0.5% (5-aminosalicylic acid agents). There was no difference seen between 6-MP and placebo, although this was a low certainty result due to imprecision from very low event numbers and patient numbers. There is a probably increased occurrence of pancreatitis when azathioprine is used in Crohn's disease (moderate certainty), with incidence overall approximately 3.8%. Most cases are mild and resolve on cessation of therapy and no mortality was reported. There was no increased occurrence seen when using 6-MP, although this is a low certainty finding. PROSPERO prior to the study (CRD42019138065).
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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.