Thiopurine S-methyltransferase polymorphisms and thiopurine toxicity in treatment of inflammatory bowel disease

Abstract

This meta-analysis suggests that the TPMT polymorphisms are associated with thiopurine-induced overall ADRs and BMT, but not with hepatotoxicity and pancreatitis.

Identification of Patients With Variants in TPMT and Dose Reduction Reduces Hematologic Events During Thiopurine Treatment of Inflammatory Bowel Disease

“…hepatotoxicity, malaise and pancreatitis do not seem to be linked to low TPMT activity, as a meta-analysis of 1309 patients confirmed. 20 The meta-analysis did, however, show a higher rate of bone marrow toxicity and overall ADR development (i.e. all ADRs that required dose reduction).…”

“…Other patients that did not start medication were also included in the planned medication group. 4 n=323, 5 9 14 (1-109) 12 15 (1-102) 15 CD patients 16 (1-109) 10 16 (1-109) 13 16 (1-102) 16 UC patients 12.5 (1-95) 11 14 (1-95) 14 10 ( 17 Baseline CRP 8 (0-284) 18 8 (0.6-214) 21 7 (0-284) 24 CD patients 9 (0.6-284) 19 8 (0.6-91) 22 10 (0.6-284) 254 UC patients 6 (0-214) 20 7 (1-214) 23 5 (0-180) 26 % …”

Methotrexate vs Azathioprine in Second-line Therapy of Sarcoidosis

“…23 Another option might be that P jiroveci pneumonia prophylaxis was only introduced halfway into the inclusion period in the azathioprine group, which currently is routine practice in this group. We did not perform thiopurine methyltransferase genotyping 24 in the patients treated with azathioprine.…”

Clinical Utility of Biomarkers in IBD

“…(Genetic) biomarkers for the prediction of the response to therapy are almost only available in the context of azathioprine and 6-mercaptopurine therapy [56][57][58].…”