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Safe treatment of thiopurine S-methyltransferase deficient Crohn's disease patients with azathioprine

Kaskas, B A; Louis, E; Hindorf, Ulf LU ; Schaeffeler, E; Deflandre, J; Graepler, F; Schmiegelow, K; Gregor, M; Zanger, U M and Eichelbaum, M, et al. (2003) In Gut 52(1). p.140-142
Abstract
Thiopurine S-methyltransferase (TPMT) deficient patients develop life threatening haematotoxicity (for example, pancytopenia) when treated with a standard dose of azathioprine (AZA) and 6-mercaptopurine (6-MP) due to excessive accumulation of cytotoxic metabolites. At present, it is generally recommended that these patients should not receive AZA or 6-MP treatment for inflammatory bowel disease. We report for the first time that Crohn's disease patients with TPMT deficiency can be successfully treated with AZA. We illustrate this with three cases where treatment has been successful and toxicity has been avoided by carefully titrating the drug dose. Thus very low TPMT activity demands pharmacogenetically guided dosing.
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type
Contribution to journal
publication status
published
subject
in
Gut
volume
52
issue
1
pages
140 - 142
publisher
BMJ Publishing Group
external identifiers
  • pmid:12477776
  • scopus:0037214334
ISSN
1468-3288
DOI
10.1136/gut.52.1.140
language
English
LU publication?
no
id
da5063d1-7a97-4441-9daf-a085f0fb65fb (old id 1126605)
date added to LUP
2008-06-11 09:46:51
date last changed
2017-09-17 07:29:40
@article{da5063d1-7a97-4441-9daf-a085f0fb65fb,
  abstract     = {Thiopurine S-methyltransferase (TPMT) deficient patients develop life threatening haematotoxicity (for example, pancytopenia) when treated with a standard dose of azathioprine (AZA) and 6-mercaptopurine (6-MP) due to excessive accumulation of cytotoxic metabolites. At present, it is generally recommended that these patients should not receive AZA or 6-MP treatment for inflammatory bowel disease. We report for the first time that Crohn's disease patients with TPMT deficiency can be successfully treated with AZA. We illustrate this with three cases where treatment has been successful and toxicity has been avoided by carefully titrating the drug dose. Thus very low TPMT activity demands pharmacogenetically guided dosing.},
  author       = {Kaskas, B A and Louis, E and Hindorf, Ulf and Schaeffeler, E and Deflandre, J and Graepler, F and Schmiegelow, K and Gregor, M and Zanger, U M and Eichelbaum, M and Schwab, M},
  issn         = {1468-3288},
  language     = {eng},
  number       = {1},
  pages        = {140--142},
  publisher    = {BMJ Publishing Group},
  series       = {Gut},
  title        = {Safe treatment of thiopurine S-methyltransferase deficient Crohn's disease patients with azathioprine},
  url          = {http://dx.doi.org/10.1136/gut.52.1.140},
  volume       = {52},
  year         = {2003},
}