Safety and Efficacy of 6-thioguanine as a Second-line Treatment for Autoimmune Hepatitis
Abstract
Corticosteroids and azathioprine provide complete response with good tolerance in most patients for the treatment of autoimmune hepatitis (AIH). Although some patients require second-line treatments, scarce data and side effects hamper consensus on them. Inflammatory bowel diseases (IBD) yielded increasing consideration for azathioprine metabolism and the use of 6-Mercaptopurine (6-MP) or 6-Thioguanine (6-TG), which both exhibit a more direct metabolism to the active metabolite of azathioprine: 6-thioguanine nucleotides (6-TGN).3 Data regarding thiopurines substitution as a second-line therapy for AIH are limited and even more so regarding 6-TG. We herein report our experience with 6-TG after azathioprine failure or intolerance.
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