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Thiopurines are established treatments for inflammatory bowel disease (IBD), yet concerns remain regarding their safety.

To evaluate the use of thiopurine‐allopurinol combination therapy compared to standard thiopurine therapy in IBD.

We performed a multicentre, randomised, placebo‐controlled trial to compare the efficacy and safety of thiopurine‐allopurinol versus thiopurine with placebo for adults commencing a thiopurine for IBD. Patients had active disease at baseline; dosing of therapy was based on a pre‐specified regimen and subsequent metabolites. The primary outcome was the proportion of patients achieving a composite of symptomatic disease activity remission (Harvey Bradshaw Index <5 for Crohn's disease, Simple Clinical Colitis Activity Index <4 for ulcerative colitis) and a faecal calprotectin <150 μg/g after 26 weeks of treatment.

The trial was terminated …