Inflammatory Bowel Disease Pharmacology, Part 1
Aminosalicylates · Corticosteroids · Thiopurines · Methotrexate
Aminosalicylates (5-ASA Agents)
Sulfasalazine
Prodrug Cleaved by Colonic Bacteria
- Azo bond links mesalamine + sulfapyridine carrier
- Bacteria cleave azo bond → mesalamine released in colon
- Sulfapyridine causes most adverse effects
- Requires: folic acid 1 mg daily (folate absorption inhibited)
- Requires: screen for glucose-6-phosphate dehydrogenase deficiency
Mesalamine Formulations
Site-Specific Delivery Without Sulfapyridine
- pH-release coatings: dissolve at pH 6–7 → terminal ileum + colon
- Multi-matrix (once daily): slow release throughout entire colon; best adherence
- Rectal suppository: rectum and distal 15 cm
- Enema: left colon to splenic flexure
- Oral + rectal combination is superior to either alone in left-sided UC
Corticosteroids in IBD
| Agent |
Bioavailability |
Best Use |
Key Limitation |
| Prednisone |
~80–100% |
Moderate–severe UC and CD; disease beyond ileum |
Full systemic adverse effects; no maintenance role; steroid dependence = escalate |
| Budesonide (ileal-release) |
10–15% (first-pass CYP3A4) |
Mild–moderate ileocaecal CD |
Not effective for colonic CD; CYP3A4 inhibitors increase systemic exposure |
| IV methylprednisolone |
Parenteral |
Severe acute UC |
Assess response at day 3; rescue if no response (infliximab or cyclosporine) |
Thiopurines: Three Competing Pathways
Anabolic Pathway (Desired)
HGPRT → 6-TGN
- 6-thioguanine nucleotides incorporated into lymphocyte DNA
- Terminates lymphocyte proliferation
- Therapeutic target: 6-TGN levels 235–450 pmol
- Onset: 3–6 months
Catabolic Pathway
Xanthine Oxidase → Thiouric Acid
- Inactive metabolite — eliminated renally
- Allopurinol blocks this pathway
- Blocking without dose reduction → fatal myelosuppression
Methylation Pathway
TPMT → 6-MMP
- 6-methylmercaptopurine: inactive but hepatotoxic at high levels
- Poor metabolizers (0.3%): no TPMT → all flux to 6-TGN → myelosuppression
- Test TPMT and NUDT15 before starting
- Poor metabolizers: reduce dose to ~10% or avoid
Methotrexate in IBD
Key Pharmacology
Folate Antagonist → Adenosine Release
- Dihydrofolate reductase inhibition → polyglutamate accumulation
- Adenosine release → suppresses T-cell proliferation and cytokines
- Parenteral route preferred (variable oral absorption)
- Folic acid 1 mg daily: reduces mucosal and marrow toxicity
- Indicated: Crohn's disease (not ulcerative colitis)
Safety Rules
Monitoring and Contraindications
- Teratogenic: absolute contraindication in pregnancy
- Contraception mandatory; stop 3 months before conception
- Hepatotoxicity: check liver function tests every 4–8 weeks
- Myelosuppression: check complete blood count every 4–8 weeks
- Contraindicated: glomerular filtration rate below 30 mL/min
Critical Rule — Allopurinol + Thiopurine
Allopurinol blocks xanthine oxidase, the catabolic thiopurine pathway. Co-prescribing at full doses causes fatal myelosuppression. Always check for thiopurine use before prescribing allopurinol. If intentional combination: reduce azathioprine to 25–33% immediately.