British medical bulletin · 2020
Thiopurines and non-melanoma skin cancer: partners in crime in inflammatory bowel diseases.
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Solitano Virginia, D'Amico Ferdinando, Correale Carmen, Peyrin-Biroulet Laurent, Danese Silvio
Аннотация
INTRODUCTION: Several studies have shown that inflammatory bowel diseases (IBD) patients treated with thiopurines have an increased risk of developing skin cancer.
SOURCES OF DATA: This review is based on recent published literature regarding the use of thiopurines in IBD and skin malignancies.
AREAS OF AGREEMENT: Exposure to thiopurines is significantly associated with nonmelanoma skin cancer, but not with melanoma. Primary and secondary prevention including sun-protective measures and regular dermatologic screening are recommended in IBD patients, particularly in those exposed to thiopurines.
AREAS OF CONTROVERSY: Both when and how immunosuppressive therapy should be resumed in patients with a prior history of skin cancer still remain debatable topics.
GROWING POINTS: The benefit-risk balance between thiopurine therapy and risk of skin cancer should be evaluated in the drug decision process.
AREAS TIMELY FOR DEVELOPING RESEARCH: The approval of new effective strategies requires the re-evaluation of the positioning of thiopurines within the therapeutic algorithm based on an increasingly individualized approach.
SOURCES OF DATA: This review is based on recent published literature regarding the use of thiopurines in IBD and skin malignancies.
AREAS OF AGREEMENT: Exposure to thiopurines is significantly associated with nonmelanoma skin cancer, but not with melanoma. Primary and secondary prevention including sun-protective measures and regular dermatologic screening are recommended in IBD patients, particularly in those exposed to thiopurines.
AREAS OF CONTROVERSY: Both when and how immunosuppressive therapy should be resumed in patients with a prior history of skin cancer still remain debatable topics.
GROWING POINTS: The benefit-risk balance between thiopurine therapy and risk of skin cancer should be evaluated in the drug decision process.
AREAS TIMELY FOR DEVELOPING RESEARCH: The approval of new effective strategies requires the re-evaluation of the positioning of thiopurines within the therapeutic algorithm based on an increasingly individualized approach.