Thiopurines in Inflammatory Bowel Diseases : New perspectives to optimise safety and efficacy

D.R. Wong

Research output: ThesisDoctoral ThesisInternal

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Patients with Crohn's disease and ulcerative colitis are frequently prescribed thiopurines as a maintenance treatment (azathioprine and 6-mercaptopurine). The degradation of thiopurines causes the generation of 6-TGN, which is important for the therapeutic effect but also can be harmful to the white blood cells, and the generation of 6-MMPR metabolites, which usually lead to premature termination of the treatment related to the development of liver damage and unpleasant side effects such as nausea and vomiting.

This PhD dissertation describes research into the usefulness of measuring these degradation products. The measurement of these degradation products after one week of treatment predicts the occurrence of these side effects. It appears that the dosage is often too low and that one in six patients does not comply with the therapy. The measurement of degradation products offers significant opportunities to improve the effectiveness and safety of thiopurines.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Maastricht University
  • Masclee, Ad, Supervisor
  • Neef, Kees, Supervisor
  • Hooymans, P.M., Co-Supervisor, External person
  • Engels, L.G.J.B., Co-Supervisor
Award date9 Jan 2015
Place of PublicationMaastricht
Print ISBNs9789461593887
Publication statusPublished - 1 Jan 2015


  • Crohn's disease
  • ulcerative colitis
  • treatment
  • thiopurines
  • degradation products

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