The role of thiopurine metabolites in inflammatory bowel disease and rheumatological disorders

被引：8

作者：

Friedman, Antony B. ^{[1
]}

Sparrow, Miles P.

Gibson, Peter R.

机构：

[1] Alfred Hosp, Dept Gastroenterol, Melbourne, Vic 3004, Australia

来源：

INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES | 2014年 / 17卷 / 02期

关键词：

6-methymercaptopurine; 6-thioguanine nucleotide; inflammatory bowel disease; thiopurines; 6-THIOGUANINE NUCLEOTIDE; CROHNS-DISEASE; LONG-TERM; METHYLTRANSFERASE ACTIVITY; DOUBLE-BLIND; AZATHIOPRINE METABOLITES; S-METHYLTRANSFERASE; COMBINATION THERAPY; ADVERSE EVENTS; 6-MERCAPTOPURINE;

D O I：

10.1111/1756-185X.12204

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Thiopurines have been a cornerstone of medical management of patients with inflammatory bowel disease (IBD) and many rheumatological disorders. The thiopurines are metabolized to their end products, 6-methymercaptopurine (6MMP) and the 6-thioguanine nucleotides (6TGN), with 6TGN being responsible for thiopurine efficacy by causing apoptosis and preventing activation and proliferation of T-lymphocytes. In IBD, conventional weight-based dosing with thiopurines leads to an inadequate response in many patients. Utilizing measurement of these metabolites and then employing dose optimization strategies has led to markedly improved outcomes in IBD. Switching between thiopurines as well as the addition of low-dose allopurinol can overcome adverse events and elevate 6TGN levels into the therapeutic window. There is a paucity of data on thiopurine metabolites in rheumatological diseases and further research is required.

引用

页码：132 / 141

页数：10

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