Mercaptopurine metabolite results in clinical gastroenterology practice
作者： R. S. Bloomfeld , J. E. Onken
DOI: 10.1046/J.1365-2036.2003.01392.X
关键词:
摘要: Background Azathioprine (AZA) and its active metabolite mercaptopurine (MP) are frequently used in the management of inflammatory bowel disease. Measurement AZA/MP metabolites, thioguanine (TG) methylmercaptopurine (MMP), has been suggested as a means to optimize therapy with Aim To evaluate results initial panels sent by gastroenterologists during first year widespread availability. Methods Initial single laboratory were reviewed interpreted. Results levels for 9187 patients. Noncompliance was detected 263 patients (3%) under-dosing 4260 (46%). 534 (6%) had that consistent preferential metabolism via TPMT pathway. The therapeutic goal achieved 2444 (27%) an additional 552 appropriate TG but potential hepatotoxicity. 936 (10%) deficiency, 58 (1%) absence at risk leukopenia. 140 (2%) too high dose. Conclusions metabolites can be practising identify reasons nonresponse AZA or MP, certain drug-related toxicities.
sci-hub.se 参考文章(21)
E. G. Seidman, M. Dubinsky, H. Patriquin, G. Marx, Y. Théorêt, Recent developments in the diagnosis and management of paediatric inflammatory bowel disease Springer, Dordrecht. pp. 87- 95 ,(2000) , 10.1007/978-94-011-4002-7_9
Adler Dj, Korelitz Bi, The therapeutic efficacy of 6-mercaptopurine in refractory ulcerative colitis. The American Journal of Gastroenterology. ,vol. 85, pp. 717- 722 ,(1990)
James L. Rosenberg, Alfred J. Wall, Bernard Levin, Henry J. Binder, Joseph B. Kirsner, A controlled trial of azathioprine in the management of chronic ulcerative colitis. Gastroenterology. ,vol. 69, pp. 96- 99 ,(1975) , 10.1016/S0016-5085(19)32641-1
Richard M. Weinshilboum, Susan L. Sladek, Mercaptopurine pharmacogenetics: monogenic inheritance of erythrocyte thiopurine methyltransferase activity. American Journal of Human Genetics. ,vol. 32, pp. 651- 662 ,(1980)
C Cuffari, E G Seidman, S Latour, Y Théorêt, Quantitation of 6-thioguanine in peripheral blood leukocyte DNA in Crohn's disease patients on maintenance 6-mercaptopurine therapy Canadian Journal of Physiology and Pharmacology. ,vol. 74, pp. 580- 585 ,(1996) , 10.1139/Y96-056
C Cuffari, Utilisation of erythrocyte 6-thioguanine metabolite levels to optimise azathioprine therapy in patients with inflammatory bowel disease Gut. ,vol. 48, pp. 642- 646 ,(2001) , 10.1136/GUT.48.5.642
L. Lennard, The clinical pharmacology of 6-mercaptopurine. European Journal of Clinical Pharmacology. ,vol. 43, pp. 329- 339 ,(1992) , 10.1007/BF02220605
Jean–frédéric Colombel, Nicolas Ferrari, Hervé Debuysere, Philippe Marteau, Jean–pierre Gendre, Bruno Bonaz, Jean-claude Soulé, Robert Modigliani, Yvan Touze, Pascale Catala, Christian Libersa, Franck Broly, Genotypic analysis of thiopurine S-methyltransferase in patients with Crohn's disease and severe myelosuppression during azathioprine therapy Gastroenterology. ,vol. 118, pp. 1025- 1030 ,(2000) , 10.1016/S0016-5085(00)70354-4
Hèctor Corominas, Montserrat Domènech, Dolors González, César Diaz, Martín Roca, Maria Asunción García-González, Salvador Peña, Montserrat Baiget, None, Allelic variants of the thiopurine s-methyltranferase deficiency in patients with ulcerative colitis and in healthy controls The American Journal of Gastroenterology. ,vol. 95, pp. 2313- 2317 ,(2000) , 10.1016/S0002-9270(00)01048-0
Marla C. Dubinsky, Philip V. Hassard, Lori Y. Kam, Maria T. Abreu, Ernest G. Seidman, Stephan R. Targan, Eric A. Vasiliauskas, Serial 6-mercaptopurine (6-MP) metabolite measurements in combination with dose escalation unmasks an important biochemical explanation for "6-MP resistance" Gastroenterology. ,vol. 118, pp. A890- ,(2000) , 10.1016/S0016-5085(00)85698-X