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

[en] Thiopurine S-methyltransferase (TPMT) deficient patients develop life threatening haematoxicity (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.

Disciplines :

Gastroenterology & hepatology

Author, co-author :

Kaskas, B. A.

Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie

Hindorf, U.

Schaeffeler, E.

Deflandre, Jean-Luc ; Centre Hospitalier Universitaire de Liège - CHU > HOPITAL DE JOUR

Graepler, F.

Schmiegelow, K.

Gregor, M.

Zanger, U. M.

Eichelbaum, M.

Schwab, M.

Language :

English

Title :

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

Publication date :

January 2003

Journal title :

Gut

ISSN :

0017-5749

eISSN :

1468-3288

Publisher :

British Med Journal Publ Group, London, United Kingdom

Volume :

Issue :

Pages :

140-142

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 25 September 2009

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Scopus citations^®

147

Scopus citations^®
without self-citations

126

OpenCitations

115

OpenAlex citations

152

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