Monitoring 6‐thioguanine nucleotide concentrations in Japanese children and adolescents with inflammatory bowel disease

Ohtsuka, Yoshikazu; Arai, Katsuhiro; Aoyagi, Yo; Fujii, Tohru; Yamakawa, Yoko; Ohtani, Kiyotaka; Ikuse, Tamaki; Baba, Yosuke; Inage, Eisuke; Kudo, Toshifumi; Suzuki, Ryuyo; Nagata, Satoru; Shimizu, Toshiaki

doi:10.1111/j.1440-1746.2010.06364.x

Cited by 21 publications

(21 citation statements)

References 21 publications

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“…These results are similar to those of a study conducted in the Far East, however, different from studies reported in Western countries 60,61,62,66. One explanation for this might be an ethnic difference.…”

Section: Discussionsupporting

confidence: 85%

“…A study of Japanese children with IBD showed that similar 6-TGN concentrations should be targeted to maintain remission, although the amounts of AZA required to achieve the targeted 6-TGN concentration were lower than those used in Western countries 62,63. In Korea, lower doses of AZA (approximately 1.5-2 mg/kg AZA per day) are empirically used for the treatment of IBD patients 64,65.…”

Section: Discussionmentioning

confidence: 99%

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Monitoring Thiopurine Metabolites in Korean Pediatric Patients with Inflammatory Bowel Disease

2014

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PurposeThis study aimed to assess the role of thiopurine S-methyltransferase (TPMT) and 6-thioguanine nucleotide (6-TGN) as predictors of clinical response and side effects to azathioprine (AZA), and estimate the optimal AZA dose in Korean pediatric inflammatory bowel disease (IBD) patients.Materials and MethodsOne hundred and nine pediatric IBD patients in whom AZA treatment was required were enrolled. Thiopurine metabolites were monitored since September 2010. Among them, 83 patients who had prescribed AZA for at least 3 months prior to September 2010 were enrolled and followed until October 2011 to evaluate optimal AZA dose, adverse effects and disease activity before and after thiopurine metabolite monitoring.ResultsThe result of the TPMT genotype was that 102 patients were *1/*1 (wild type), four were *1/*3C, one was *1/*6, one was *1/*16 (heterozygote) and one was *3C/*3C (homozygote). Adverse effects happened in 31 patients pre-metabolite monitoring and in only nine patients post-metabolite monitoring. AZA dose was 1.4±0.31 mg/kg/day before monitoring and 1.1±0.46 mg/kg/day after monitoring (p<0.001). However, there were no statistical differences in disease activity during metabolite monitoring period (p=0.34). Adverse effects noticeably decreased although reduction of the AZA dose since monitoring.ConclusionTPMT genotype and thiopurine metabolite monitoring could be helpful to examine TPMT genotypes before administering AZA and to measure 6-TGN concentrations during prescribing AZA in IBD patients.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Monitoring Thiopurine Metabolites in Korean Pediatric Patients with Inflammatory Bowel Disease

2014

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“…However, these recommendations do not necessarily hold true for other ethnicities. Several Japanese studies showed that Japanese IBD patients might reach sufficient 6-TGN values with substantially lower AZA dosages in adults, children and adolescents [22-24]. …”

Section: Metabolism and Monitoring Of Thiopurinesmentioning

confidence: 99%

Monitoring and Safety of Azathioprine Therapy in Inflammatory Bowel Disease

Kim

Choe

2013

Pediatr Gastroenterol Hepatol Nutr

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Azathioprine is the most common drug used to maintain clinical remission in inflammatory bowel disease. This drug is also important as a steroid-sparing agent in steroid-dependent and chronically active inflammatory bowel disease. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine. The dose of azathioprine has to be reduced or the therapy has to be discontinued frequently because of drug-induced toxicity. In this review, we discuss monitoring of thiopurines, adverse events, malignant complications and how to use azathioprine safely and usefully.

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“…Concerning the relationship between preoperatively administered medications and SSI, we did not monitor 6-thioguanine nucleotide concentrations in patients receiving AZA (30) or trough serum con/ss in those receiving TAC (31), CYA (32), or IFX (33) in this study; we therefore could not investigate the relationship between serum concentrations of drugs and postoperative infectious complications.…”

Section: Discussionmentioning

confidence: 99%

Immunosuppressive medication is not associated with surgical site infection after surgery for intractable ulcerative colitis in children

Uchida

Ohtsuka

Yoden

et al. 2017

IRDR

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Monitoring 6‐thioguanine nucleotide concentrations in Japanese children and adolescents with inflammatory bowel disease

Abstract: The doses of 6-MP or AZA needed to maintain remission in Japanese children with IBD are lower than those reported in Western countries. However, 6-TGN concentrations in this population are higher than previously reported.

Cited by 21 publications

References 21 publications

Monitoring Thiopurine Metabolites in Korean Pediatric Patients with Inflammatory Bowel Disease

Monitoring Thiopurine Metabolites in Korean Pediatric Patients with Inflammatory Bowel Disease

Monitoring and Safety of Azathioprine Therapy in Inflammatory Bowel Disease

Immunosuppressive medication is not associated with surgical site infection after surgery for intractable ulcerative colitis in children

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