Thiopurine methyltransferase activity and the use of azathioprine in inflammatory bowel disease

摘要: Background: Azathioprine therapy is discontinued in one-third of patients with inflammatory bowel disease because toxicity or a lack clinical response. Patients thiopurine methyltransferase (TPMT) deficiency are intolerant to azathioprine, whilst carriers at increased risk side-effects. Aim: To evaluate the importance TPMT activity management azathioprine disease. Methods: Clinical response, adverse effects and haematological parameters were determined correlated enzyme genotype 106 Results: Ninety-six had high activity, 10 intermediate activity. Nineteen (18%) azathioprine. Fifteen (16%) those intolerant, compared five (50%) [odds ratio (OR), 5.4; 95% confidence interval (CI), 1.5-19.8]. Complete remission was achieved 63% cases, complete partial 79%. Interestingly, very (>14 units/mL red blood cells) significantly associated non-response, irrespective time on (OR, 0.21; CI, 0.07-0.68). gene mutations Conclusions: Inflammatory have an toxicity. Conversely, predicts treatment failure. predicted phenotype this study.