{"doi":"10.1093/ibd/izab232","title":"Impact of Thiopurine Exposure on Immunogenicity to Infliximab Is Negligible in the Setting of Elevated Infliximab Concentrations","abstract":"Infliximab (IFX), a chimeric monoclonal antibody targeting tumor necrosis factor-α, is an important anticytokine treatment for inflammatory bowel disease (IBD). Although IFX is efficacious at inducing and maintaining clinical and endoscopic remission, a key limitation is immunogenicity. Recognition of the fragment antigen-binding sequence and murine portion of IFX by the immune system can lead to activation and formation of anti-IFX antibodies that can neutralize IFX, leading to reduced drug exposure and loss of response.1 Use of thiopurines, such as 6-mercaptopurine and azathioprine, with IFX has been shown to be beneficial in IBD in randomized controlled clinical trials.2 Although combination thiopurine and IFX treatment is advocated by many society guidelines, there are safety concerns associated with combination therapy that limit its use. For example, thiopurines can result in leukopenia, particularly in those with deficiencies in thiopurine metabolizing enzymes (thiopurine methyltransferase [TPMT] and nudix hydrolase 15 [NUDT15]).3 There is...","journal":"Inflammatory Bowel Diseases","year":2021,"id":189140,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9548,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":109042,"name":"Jean‐Frédéric Colombel","orcid":"0000-0001-6472-249X","position":1,"is_corresponding":false},{"id":235305,"name":"Marla C. Dubinsky","orcid":"0000-0003-4968-5795","position":2,"is_corresponding":false},{"id":411135,"name":"Anjali Jain","orcid":"0000-0001-5658-367X","position":3,"is_corresponding":false},{"id":749347,"name":"Thierry Dervieux","orcid":"0000-0002-3799-4438","position":4,"is_corresponding":false},{"id":109031,"name":"Ryan C. Ungaro","orcid":"0000-0001-8687-3758","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-18T23:49:14.547082Z","pmid":"34536078","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}