6-mercaptopurine + infliximab

6-mercaptopurine + infliximab is a combination therapy used primarily in the management of Crohn's disease, particularly for patients with fistulizing or refractory disease. 6-mercaptopurine is an immunosuppressive purine analogue that inhibits DNA and RNA synthesis, thereby suppressing immune cell proliferation and reducing inflammation. Infliximab is a chimeric monoclonal antibody that targets tumor necrosis factor-alpha (TNF-alpha), a key cytokine involved in inflammatory processes. By combining these two agents, the regimen aims to enhance clinical remission rates, promote fistula closure, and reduce the formation of antibodies against infliximab (which can decrease its efficacy). This combination has been shown to be more effective than monotherapy with either agent for inducing and maintaining remission in Crohn’s disease[1][4][7]. The use of this combination may also help maintain higher trough levels of infliximab and prolong its therapeutic effect[2][3].