| Theme | Role of AZA/6-MP in the Treatment of Inflammatory Bowel Disease | |
|---|---|---|
| Title | Optimizing Efficacy and Safety of AZA/6-MP for Inflammatory Bowel Disease -- Role of TPMT Polymorphism and 6-TGN | |
| Publish Date | 2007/11 | |
| Author | Hiroyuki Hanai | Center for Gastroenterology & IBD Research, Hamamatsu South Hospital |
| Author | Fumitoshi Watanabe | Center for Gastroenterology & IBD Research, Hamamatsu South Hospital |
| Author | Takayuki Iida | Center for Gastroenterology & IBD Research, Hamamatsu South Hospital |
| Author | Ken Takeuchi | Center for Gastroenterology & IBD Research, Hamamatsu South Hospital |
| Author | Jinro Abe | Center for Gastroenterology & IBD Research, Hamamatsu South Hospital |
| Author | Kei Ishimaru | Center for Gastroenterology & IBD Research, Hamamatsu South Hospital |
| [ Summary ] | 6-mercaptopurine and its prodrug azathioprine (thiopurines) remain the mainstays of immunomodulator therapy for maintenance of patients with inflammatory bowel disease. The enzyme thiopurine-S-methyltransferase (TPMT) controls production of 6-thioguanine nucleotides (6-TGN), responsible for thiopurine induced efficacy and myelosuppression. Although the TPMT gene is polymorphic, resulting in interindividual variations of the enzyme's activity with significant clinical relevance, adverse events limit their use. In patients failing to do well with thiopurines therapy, measurement of 6-TGN can be useful in identifying non-compliers or as a guide to further escalation. | |