Usefulness of thiopurine methyltransferase and thiopurine metabolite analysis in clinical practice in patients with inflammatory bowel diseases

被引:0
作者
Dewit, O. [1 ]
机构
[1] St Luc Univ Hosp, Dept Gastroenterol, B-1200 Brussels, Belgium
关键词
azathioprine; 6-thioguanine nucleotides (6-TGN); 6-methylmercaptopurine (6-MMP); thiopurine metabolism; thiopurine side effects; S-METHYLTRANSFERASE; CROHNS-DISEASE; AZATHIOPRINE THERAPY; COST-EFFECTIVENESS; TPMT ACTIVITY; PHARMACOGENETICS; 6-MERCAPTOPURINE; MERCAPTOPURINE; ALLOPURINOL; MYELOSUPPRESSION;
D O I
暂无
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Thiopurines (TP) are widely used in the management of inflammatory bowel diseases. Side-effects and inefficacy are a major concern as they lead to withdrawal of the drug. Tools investigating TP metabolism are useful to avoid inadequate cessation of TP therapy. TP metabolism is complex and many enzymes are involved. Among them, Thiopurine methyltransferase (TPMT) is the only one routinely measured by pheno- or genotyping. In this review, the rationale for TPMT and thiopurine metabolites, 6-thioguanine nucleotides and 6-methylmercaptopurine, determination in clinical practice is discussed, specifically in case of thiopurine failure and recommendations are given about their interpretation and potential dose optimization of TP drugs. (Acta gastroenterolog. belg., 2010, 73, 331-335)
引用
收藏
页码:331 / 335
页数:5
相关论文
共 50 条
[1]   Prospective evaluation of the pharmacogenetics of azathioprine in the treatment of inflammatory bowel disease [J].
Ansari, A. ;
Arenas, M. ;
Greenfield, S. M. ;
Morris, D. ;
Lindsay, J. ;
Gilshenan, K. ;
Smith, M. ;
Lewis, C. ;
Marinaki, A. ;
Duley, J. ;
Sanderson, J. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2008, 28 (08) :973-983
[2]   Long-term outcome of using allopurinol co-therapy as a strategy for overcoming thiopurine hepatotoxicity in treating inflammatory bowel disease [J].
Ansari, A. ;
Elliott, T. ;
Baburajan, B. ;
Mayhead, P. ;
O'Donohue, J. ;
Chocair, P. ;
Sanderson, J. ;
Duley, J. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2008, 28 (06) :734-741
[3]   Low-dose azathioprine or mercaptopurine in combination with allopurinol can bypass many adverse drug reactions in patients with inflammatory bowel disease [J].
Ansari, A. ;
Patel, N. ;
Sanderson, J. ;
O'Donohue, J. ;
Duley, J. A. ;
Florin, T. H. J. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2010, 31 (06) :640-647
[4]   Thiopurine methyltransferase activity and the use of azathioprine in inflammatory bowel disease [J].
Ansari, A ;
Hassan, C ;
Duley, J ;
Marinaki, A ;
Shobowale-Bakre, EM ;
Seed, P ;
Meenan, J ;
Yim, A ;
Sanderson, J .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2002, 16 (10) :1743-1750
[5]   Therapeutic drug monitoring of azathioprine and 6-mercaptopurine metabolites in Crohn disease [J].
Belaiche, J ;
Desager, JP ;
Horsmans, Y ;
Louis, E .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 2001, 36 (01) :71-76
[6]  
Cara CJ, 2004, MED SCI MONITOR, V10, pRA247
[7]   Genotypic analysis of thiopurine S-methyltransferase in patients with Crohn's disease and severe myelosuppression during azathioprine therapy [J].
Colombel, JF ;
Ferrari, N ;
Debuysere, H ;
Marteau, P ;
Gendre, JP ;
Bonaz, B ;
Soulé, JC ;
Modgliani, R ;
Touze, Y ;
Catala, P ;
Libersa, C ;
Broly, F .
GASTROENTEROLOGY, 2000, 118 (06) :1025-1030
[8]   Impact of the increasing use of immunosuppressants in Crohn's disease on the need for intestinal surgery [J].
Cosnes, J ;
Nion-Larmurier, I ;
Beaugerie, L ;
Afchain, P ;
Tiret, E ;
Gendre, JP .
GUT, 2005, 54 (02) :237-241
[9]   Thiopurine Methyltransferase Activity Influences Clinical Response to Azathioprine in Inflammatory Bowel Disease [J].
Cuffari, Carmen ;
Dassopoulos, Themistocles ;
Turnbough, Lisa ;
Thompson, Richard E. ;
Bayless, Theodore M. .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2004, 2 (05) :410-417
[10]   Characterization of a novel TPMT mutation associated with azathioprine-induced myelosuppression [J].
de Beaumais, Tiphaine Adam ;
Fakhoury, May ;
Pigneur, Benedicte ;
Viola, Sheila ;
Medard, Yves ;
Broly, Franck ;
Jacqz-Aigrain, Evelyne .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2009, 68 (05) :770-772