Mercaptopurine has been established as an effective treatment of inflammatory bowel disease (IBD), particularly in the long-term maintentance of remission.
However, concern about mercatopurine toxicity remains, especially its role in the development of neoplasm.
Dr Jonathan Warman and colleagues determined the incidence of toxicity by follow-up of all patients with IBD treated with mercatopurine over a 20-year period in a single institution.
Dr Warman’s team reviewed 410 patients with inflammatory bowel disease treated with mercatopurine from 1980 to 1999.
The research team report a low incidence of both early drug-related allergic reactions (3.9%) and pancreatitis (1.2%).
| Diabetes was identified as a complication of mercatopurine therapy.|
|Journal of Clinical Gastroenterology|
Desensitization to either mercatopurine or azathioprine was often found to be successful using the same or the other drug.
14% of patients had infectious complications at some point throughout their mercatopurine treatment. These complications included pneumonia in 3.9% of patients and herpes zoster in 3.0%.
The research team identified diabetes as a mercatopurine related complication.
With regards to the risk of neoplasm, there was no difference between mercatopurine treated patients and non -mercatopurine treated patients.
Dr Warman concludes “Our data support the long-term safety of mercatopurine in the management of patients with inflammatory bowel disease.”