6-Thioguanine in the Treatment of Psoriasis: A Case Report and Literature Review

Sherer, Daniel; Lebwohl, Mark

doi:10.1007/s10227-001-0140-8

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…In many other studies, TG has been effective in inducing and maintaining remission of psoriasis, however, adverse events such as myelosuppression have been observed as well [58]. It was generally considered an effective treatment for patients with resistant psoriasis and strict clinical monitoring was highly recommended [59].…”

Section: Dermatology and Rheumatologymentioning

confidence: 99%

The continuous rediscovery and the benefit–risk ratio of thioguanine, a comprehensive review

Bayoumy

Simsek

Seinen

et al. 2020

Expert Opinion on Drug Metabolism & Toxicology

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Introduction: In the 1950s, thioguanine (TG), a thiopurine-derivative together with azathioprine (AZA) and mercaptopurine (MP), were developed for the treatment of childhood leukemia. Over the years, the use of TG was also explored for other, mainly immune-mediated and inflammatory, diseases such as in the field of dermatology and rheumatology (e.g. psoriasis, systemic lupus erythematosus (SLE)) and gastroenterology and hepatology (e.g. inflammatory bowel diseases (IBD), autoimmune hepatitis).Areas covered: This review provides a comprehensive overview of all the clinical uses of TG and describes its mechanism of action, pharmacokinetic/pharmacodynamic features, and toxicity. Expert opinion: Thioguanine has shown beneficial clinical effects in hematological (particularly leukemia) and several immune-inflammatory diseases including psoriasis, SLE, polycythemia vera, Churg-Strauss syndrome, IBD, collagenous sprue, refractory celiac disease, and autoimmune hepatitis. Thioguanine is not effective in treating solid-cancers. At relatively low dosages, i.e. 0.2-0.3mg/kg/day or 20 mg/day, TG has a favorable risk-benefit ratio and is a safe and effective drug in the long-term treatment of amongst other IBD patients. Thioguanine toxicity, especially myelotoxicity, and hepatotoxicity, including nodular regenerative hyperplasia (NRH) of the liver, is limited when dosed adequately. The occurrence of NRH appears dose-dependent and has been especially described during high dose TG above 40 mg/day.

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Section: Dermatology and Rheumatologymentioning

confidence: 99%

The continuous rediscovery and the benefit–risk ratio of thioguanine, a comprehensive review

Bayoumy

Simsek

Seinen

et al. 2020

Expert Opinion on Drug Metabolism & Toxicology

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“…16–18 Recent literature reports confirm that TG drugs can be used for other diseases and clinical conditions including immunosupressants and HIV replication. 19–22 …”

Section: Introductionmentioning

confidence: 99%

New nanomedicine approaches using gold–thioguanine nanoconjugates as metallo-ligands

Sleightholm

Zambre

Chanda

et al. 2011

Inorganica Chimica Acta

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Gold-thioguanine nanoconjugates (AuNP-TG) of size 3–4 nm were synthesized and the ratio between gold and 6-Thioguanine (TG) was estimated as ~1:1.5 using a cyanide digestion method and confirmed by flame atomic absorption spectroscopic analysis. AuNP-TG constructs showed high in vitro stability under different pH conditions and biologically relevant solutions for a period of 24 hours. Reaction of AuNP-TG with europium or platinum salts resulted in the formation of organized self-assembled metallo-networks.

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“…In the RA population, there is an increased risk of serious infections and a higher rate of adverse events in patients with chronic obstructive pulmonary disease (COPD), and a requirement for ongoing monitoring for the risk of lung carcinoma and lymphoma (grade D evidence) [14]. For 6-thioguanine, there has been a high success rate, with 78% of patients clearing the majority, or all, of their lesions (grade C evidence) [15, 16]. Over 50% of the patients were able to maintain their results for 2 years.…”

Section: Resultsmentioning

confidence: 99%

A Delphi Consensus Approach to Challenging Case Scenarios in Moderate-to-Severe Psoriasis: Part 2

Strober

Cather

Cohen

et al. 2012

Dermatol Ther (Heidelb)

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IntroductionClinicians may be confronted with difficult-to-treat psoriasis cases for which there are scant data to rely upon for guidance. To assist in managing such patients, who are typically excluded from clinical trials, a consensus panel of 14 experts in the field of psoriasis was formed to conduct a Delphi method exercise.MethodsThe exercise consisted of both survey questionnaires and a live meeting to review and discuss current data (as of 2009, when the exercise was conducted) and arrive at a consensus for optimal treatment options. Seventy difficult treatment scenarios were identified, and the top 24 were selected for discussion at the live meeting.ResultsFive of the 24 discussed case scenarios are presented in this article: (1) moderate-to-severe psoriasis that has failed to respond to all currently approved therapies for psoriasis; (2) palmoplantar psoriasis that is unresponsive to topical therapy and phototherapy; (3) erythrodermic psoriasis; (4) pustular psoriasis; and (5) the preferred therapeutic choice to combine with low-dose methotrexate. A previous article (part 1) presented six other scenarios.ConclusionThe Delphi exercise resulted in guidelines for practicing physicians to utilize when confronted with patients with challenging cases of psoriasis.

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6-Thioguanine in the Treatment of Psoriasis: A Case Report and Literature Review

Cited by 11 publications

References 12 publications

The continuous rediscovery and the benefit–risk ratio of thioguanine, a comprehensive review

The continuous rediscovery and the benefit–risk ratio of thioguanine, a comprehensive review

New nanomedicine approaches using gold–thioguanine nanoconjugates as metallo-ligands

A Delphi Consensus Approach to Challenging Case Scenarios in Moderate-to-Severe Psoriasis: Part 2

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