Optimizing Thiopurine therapy in inflammatory bowel disease patients

This thesis investigates various strategies for optimizing thiopurine therapy for patients with inflammatory bowel disease (IBD). Thiopurines are widely used in IBD, but are also associated with many side effects such as nausea, reduced immunity, and liver damage. Various optimization strategies are already in place to treat patients as effectively as possible with as few side effects as possible. Examples include measuring blood levels of the active substances and determining genetic predisposition in order to predict the metabolism of these drugs in the body. In this thesis, these existing optimization strategies were further investigated, revealing, among other things, that determining blood levels can be useful after just one week and that determining the genetic profile can also be useful for all thiopurines. In addition, the first steps have been taken towards a new optimization strategy, in which the effect of the drug in white blood cells can be measured. These strategies can be used in the future to ensure that thiopurines are used as effectively and safely as possible in IBD patients.