W1099 Adequately Dosed 6-Thioguanine Is a Well Tolerated and Safe Rescue Drug in Azathioprine or 6-Mercaptopurine Intolerant IBD Patients

Abstract

G A A b st ra ct s end of follow-up. Fourteen experienced any complication, and 5 were infectious complications. These included 2 cases of shingles, and one each of PCP, EBV, and viral meningitis. No covariates predicted clinical success. Significant predictors of 6TGN levels included the dose of allopurinol, age, and BMI. Significant predictors of 6MMP levels included the doses of thiopurine and allopurinol, and BMI. Significant predictors of WBC included dosing, BMI, and age. Despite having only 5 events, there was a trend toward an association between infectious complications and low ALC (OR 7.4, p=0.14, 95% CI 0.51111). Conclusions: Adjunctive allopurinol therapy in shunting patients was successful in producing major clinical improvement in half of patients. However, in this small series, a surprising number of opportunistic infectious complications occurred. BMI has a significant modulating effect on metabolite levels and WBC levels. Low ALC may be an indicator of risk of opportunistic infections. Careful monitoring for infectious complications should be part of thiopurine plus allopurinol therapy for IBD.