[Immunosuppressants for therapy of patients with ulcerative colitis].
Ulcerative colitis (UC) has been known as inflammatory bowel disease. Progress in UC management strategies has led to optimized approaches for achieving the two primary clinical goals of therapy: induction and maintenance of remission. We here review about immunosuppressants in management of UC; Cyclosporine A (CsA) has been used for the induction therapy in steroid resistant refractory UC. Although it has been reported that CsA has high response rate in severe UC, long-term efficacy (maintenance of remission) has not been proven. To improve maintenance therapy, immunosuppressant has been re-considered in management of UC. In recent years, it has been reported that efficacy of 6-mercaptopurine/azathioprine in maintenance of remission of UC is superior to 5-aminosalicylate (5-ASA). Pharmacological studies have indicated thiopurine methyltransferase (TPMT) activity is essential for maintenance of blood concentration of 6-thioguanine nucleotide (6-TG).
Hisamatsu
Tadakazu
T
Department of Internal Medicine, Keio University School of Medicine.
Hibi
Toshifumi
T
D001379:Azathioprine / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D016572:Cyclosporine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006150:Guanine Nucleotides / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D015122:Mercaptopurine / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D008780:Methyltransferases / Q000378:metabolism; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects; D013873:Thionucleotides / Q000097:blood
D006150:Guanine Nucleotides; D007166:Immunosuppressive Agents; D013873:Thionucleotides; C003964:6-thioguanylic acid; D016572:Cyclosporine; D015122:Mercaptopurine; D008780:Methyltransferases; C022745:thiopurine methyltransferase; D009173:Mycophenolic Acid; D001379:Azathioprine; D016559:Tacrolimus