Mercaptopurine metabolite results in clinical gastroenterology practice.

Published

Journal Article

BACKGROUND: Azathioprine (AZA) and its active metabolite mercaptopurine (MP) are frequently used in the management of inflammatory bowel disease. Measurement of the AZA/MP metabolites, thioguanine (TG) and methylmercaptopurine (MMP), has been suggested as a means to optimize therapy with AZA/MP in inflammatory bowel disease. AIM: To evaluate the results of initial AZA/MP metabolite panels sent by gastroenterologists during the first year of its widespread availability. METHODS: Initial AZA/MP metabolite panels sent by gastroenterologists to a single laboratory were reviewed and the metabolite panels were interpreted. RESULTS: Initial metabolite levels were reviewed for 9187 patients. Noncompliance was detected in 263 patients (3%) and under-dosing in 4260 patients (46%). 534 patients (6%) had levels that were consistent with preferential metabolism via the TPMT pathway. The therapeutic goal was achieved in 2444 patients (27%) and an additional 552 patients (6%) had appropriate TG levels but potential hepatotoxicity. 936 patients (10%) had potential TPMT deficiency, and 58 patients (1%) had potential TPMT absence and were at risk for leukopenia. 140 patients (2%) had too high a dose. CONCLUSIONS: Measurement of AZA/MP metabolites can be used by practising gastroenterologists to identify potential reasons for nonresponse to AZA or MP, and to identify patients at risk for certain drug-related toxicities.

Full Text

Duke Authors

Cited Authors

  • Bloomfeld, RS; Onken, JE

Published Date

  • January 2003

Published In

Volume / Issue

  • 17 / 1

Start / End Page

  • 69 - 73

PubMed ID

  • 12492734

Pubmed Central ID

  • 12492734

International Standard Serial Number (ISSN)

  • 0269-2813

Digital Object Identifier (DOI)

  • 10.1046/j.1365-2036.2003.01392.x

Language

  • eng

Conference Location

  • England