Tu1166 Genetic and Serologic Associations With 6-MMP Preferential Metabolizers Reveal Novel Pathways That May Be Involved in Thiopurine Metabolism

Karsan, Sundip S.; Huang, Brian; Yoon, Jessica L.; Dubinsky, Marla C.; Berel, Dror; Yan, Xiaofei; Melmed, Gil Y.; Ippoliti, Andrew; Guo, Xiuqing; Taylor, Kent D.; Kaur, Manreet; Rotter, Jerome I.; Targan, Stephan R.; Vasiliauskas, Eric; McGovern, Dermot; Shih, David Q.

doi:10.1016/s0016-5085(13)62882-6

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“…Leukopenia may occur even with normal TPMT activity, however. Studies are underway looking for other genetic polymorphisms that might explain myelosuppression without TPMT deficiency . Correlation between thiopurine metabolite levels and clinical response in IBD was first described in 1996 .…”

Section: Commentmentioning

confidence: 99%

Allopurinol enhanced thiopurine treatment for inflammatory bowel disease: safety considerations and guidelines for use

2014

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SUMMARYWhat is known and objective: The thiopurine medications are standard inflammatory bowel disease treatments. Therapeutic failure is observed, however, often because of variable drug metabolism. Allopurinol can enhance the potency of thiopurine treatment. Our objective is to review the relevant literature, and our own experience, to determine if allopurinol enhancement of thiopurine treatment is a reasonable therapeutic strategy. Comment: Published reports of, and our own experience using, allopurinol-thiopurine combination therapy indicate that the addition of allopurinol will enhance thiopurine treatment in up to 60% of patients. There are risks to this approach, but with appropriate monitoring, these risks should approximate those observed with thiopurine therapy alone.

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Section: Commentmentioning

confidence: 99%