Tabloid (thioguanine or TG) has comparable effectiveness and side effects to conventional immunomodulator drugs in patients with inflammatory bowel disease (IBD) who did not previously respond to such treatments, a study published in the United European Gastroenterology Journal showed.
“The safety data for TG is reassuring,” the authors wrote. “We acknowledge that [the side effects], rather than the clinical effectiveness of TG, is the key message that clinicians may find most useful when translating our findings to everyday clinical practice,” they added.
For the study, titled “Thioguanine in inflammatory bowel disease: Long-term efficacy and safety,” the team of researchers led by Dr. Jeremy Sanderson from the Department of Gastroenterology at Guy’s and St. Thomas’ Hospital and Diabetes and Nutritional Sciences Division, School of Medicine, King’s College London, analyzed data from 54 IBD patients treated with Tabloid between 2001 and 2013 at Guy’s and St. Thomas’ Hospital in London.
Forty-seven of the patients had Crohn’s disease and seven had ulcerative colitis. All patients received between 20 and 40 mg of Tabloid per day. Some patients also received anti-TNF (tumor necrosis factor) drugs in conjunction with Tabloid.
The results showed that almost 60% of the patients responded to Tabloid at six months and 43% responded at 12 months. About a third of the patients stopped taking the drug due to intolerance or toxicity (including four serious cases) but no nodular regenerative hyperplasia of the liver occurred. Drug concentration did not correlate with effectiveness or toxicity.
“Head to head studies of TG versus conventional thiopurines would help establish the safety and efficacy of TG in IBD, but are unlikely to be undertaken,” the authors wrote in a news release. “Nonetheless, TG remains an acceptable alternative in patients with IBD who have not tolerated or have failed conventional immunomodulators.”
Tabloid is a chemotherapy drug that is used to treat leukemia. It has been shown to also be effective in treating IBD, but its toxicity has limited its use. One of the main side effects associated with it is nodular regenerative hyperplasia of the liver, a rare liver condition characterized by a widespread benign transformation of the liver into small regenerative nodules.