Calafat M, Mañosa M, Cañete F, et al. - Because thiopurines (azathioprine and mercaptopurine) are the most commonly used immunosuppressants in IBD, although drug-related adverse events (AE) happen in 20%-30% of cases, researchers conducted this large, retrospective study to assess the safety of thiopurines in elderly patients with IBD. Of the 48,752 IBD patients included in the ENEIDA registry, a total of 19,630 were treated with thiopurines at some time. Among them, at age over 60, 1,888 patients started thiopurines and were compared with 15,477 adult patients who started thiopurines between the ages of 18 and 50 years. Higher rates of all types of myelotoxicity, digestive intolerance, and hepatotoxicity were found in patients starting at > 60. Thiopurines have been discontinued in more patients starting > 60 years due to AEs (excluding malignancies and infections). Independent risk factors for most AEs were elderly age and female gender. Overall, the authors concluded that thiopurines are linked to an increased risk of non-infectious, non-neoplastic, AEs in elderly IBD patients.