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Mycophenolate mofetil following intolerance or failure of thiopurine therapy in inflammatory bowel diseases

ment response in clinical routine. Dr van Asseldonk highlights in his comments, some of the limitations of our study that are also some of the concerns that limit the applicability of the theoretical issues of the thiopurine metabolism into a real-life clinical scenario. Moreover, we would like to emphasise that we could not find any cut-off value of TPMT or 6TGN that could be useful for clinical practice. In conclusion, it seems obvious that more research is needed to clarify the proper role, if any, that the serum determination of TPMT and azathioprine metabolites may play, especially if trying to adjust or optimise the dose of thiopurines, in clinical practice. Other specific clinical situations in which those serum determinations may be of help should be further investigated.