{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T13:05:20Z","timestamp":1779541520748,"version":"3.53.1"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"abstract":"<jats:p>\n                    Acute pancreatitis is a rare adverse effect of thiopurines. The present study aimed to investigate the frequency, rate, and risk factors for pancreatitis in thiopurine users. This population-based retrospective cohort study. We included all patients treated with thiopurine for any indication between 2000 and 2022. A recorded diagnosis of pancreatitis after the initiation of thiopurine treatment. This population-based retrospective cohort study. A total of 19,348 patients were enrolled in the present study. 15,685 (81.1%) patients were treated with azathioprine, while 3663 (18.9%) were treated with 6-Mercaptopurine. Acute pancreatitis was recorded in 421 (2.2%) of all patients. Patients with pancreatitis were aged 45.5\u2009\u00b1\u200917.5 vs 45.8\u2009\u00b1\u200919,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.723), had higher rates of smoking (35.9% vs 22.5%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), had a higher proportion of mercaptopurine use (26.1% vs 18.8%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), had more Crohn\u2019s disease (51.8% vs 34.3%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and had a higher all-cause mortality rate (22.1% vs 16.8%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.004). Pancreatitis was most common among Crohn\u2019s disease patients, with 3.2% of Crohn\u2019s disease patients treated with thiopurines compared to other diseases. In a multivariant analysis smoking and Crohn\u2019s disease were found to be independent risk factors for pancreatitis (OR 1.904, 95% CI 1.555\u20132.331,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001, OR 1.938, 95% CI 1.580\u20132.376,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001, respectively). This large, population-based study demonstrates that acute pancreatitis is a relatively rare but significant adverse effect associated with thiopurine use, with a frequency rate of 2.2% of patients. Notably, Crohn\u2019s disease and smoking were found to be significant risk factors for developing pancreatitis, which highlights the importance of closely monitoring high-risk patients.\n                  <\/jats:p>","DOI":"10.1177\/10815589261448843","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:09:28Z","timestamp":1777378168000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Frequency and predictors for pancreatitis among patients treated with thiopurine: A large database study"],"prefix":"10.1177","author":[{"given":"Heba","family":"Abu-Kaf","sequence":"first","affiliation":[{"name":"Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaser","family":"Afianish","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Abosbet","sequence":"additional","affiliation":[{"name":"Internal Medicine Ward, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Abu-Saris","sequence":"additional","affiliation":[{"name":"Internal Medicine Ward, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Weissmann","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roba","family":"Ganayem","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4844-3308","authenticated-orcid":false,"given":"Naim","family":"Abu-Freha","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008571-199608000-00001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-126-8-199704150-00003"},{"key":"e_1_3_2_4_2","volume-title":"Medical genetics summaries","author":"Dean L","year":"2012","unstructured":"Dean L. Azathioprine therapy and TPMT and NUDT15 genotype. In: Pratt VM, Scott SA, Pirmohamed M, Esquivel B, Kattman BL, Malheiro AJ (ed.) Medical genetics summaries. Bethesda (MD): National Center for Biotechnology Information (US), 2012."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12216742"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Hussain Y Khan H. Immunosuppressive drugs. 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