azathioprine + 6-mercaptopurine

Azathioprine and 6-mercaptopurine are thiopurine immunomodulators used primarily for the maintenance of remission in inflammatory bowel diseases, including Crohn's disease. Azathioprine acts as a prodrug that is non-enzymatically cleaved to 6-mercaptopurine, which is then further metabolized into active thioguanine nucleotides. These metabolites incorporate into DNA and inhibit de novo purine synthesis, leading to the suppression of T- and B-lymphocyte proliferation and a reduction in immune-mediated inflammation. In clinical practice and trials like the PIBD-Net study (NCT02852694), they are often used interchangeably or as a treatment arm to maintain steroid-free remission in pediatric patients.

Brand names

ImuranPurinethol

Other names

AZA6-MPthiopurinesazathioprine/6-mercaptopurine