Safety of Thioguanine in Pediatric Inflammatory Bowel Disease: A Multi-Center Case Series

Ahmed B. Bayoumy, Jasmijn Z. Jagt, Herbert M. Van Wering, Lissy De Ridder, Thalia Hummel, Victorien M. Wolters, Janneke Stapelbroek, Marc A. Benninga, Chris J.J. Mulder, Nanne K.H. De Boer, Tim G.J. De Meij*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
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Objectives: Thioguanine (TG) has been shown as a safe alternative in adults with inflammatory bowel disease (IBD) who did not tolerate conventional thiopurines [azathioprine (AZA)/mercaptopurine]. However, data in pediatric IBD are scarce. Therefore, we aimed to assess the safety of TG as maintenance therapy. Methods: A retrospective, multicenter cohort study of children with IBD on TG was performed in the Netherlands. TG-related adverse events (AE) were assessed and listed according to the common terminology criteria for AE. Results: Thirty-six children with IBD (median age 14.5 years) on TG (median dose 15 mg/day) were included in 6 centers. Five AE occurred during follow-up [pancreatitis (grade 3), hepatotoxicity (grade 3) (n = 2), Clostridium difficile infection (grade 2), and abdominal pain (grade 2)]. All patients (n = 8) with a previously AZA-induced pancreatitis did not redevelop pancreatitis on TG. Conclusions: In pediatric IBD, TG seems a safe alternative in case of AZA-induced pancreatitis. Further research assessing long-Term TG-related safety and efficacy is needed.

Original languageEnglish
Pages (from-to)E111-E115
JournalJournal of Pediatric Gastroenterology and Nutrition
Issue number6
Publication statusPublished - 1 Dec 2022

Bibliographical note

Funding Information:
N.K.H.d.B has served as a speaker for AbbVie and MSD has served as consultant and/or principal investigator for TEVA Pharma BV and Takeda. He has received a (unrestricted) research grant from Dr Falk, TEVA Pharma BV, MLDS and Takeda. L.d.R. has been involved in industry sponsored studies, investigator initiated study and/or consultancy with AbbVie, Lilly, Takeda, Janssen and Pfizer and received research grants from ZonMw, ECCO, and Pfizer. All authors declare that they have seen and approved the final version of the manuscript. The remaining authors report no conflicts of interest.

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© 2022 Lippincott Williams and Wilkins. All rights reserved.


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