The thiopurine drugs are purine antimetabolites widely used in the treatment of acute lymphoblastic leukemia, autoimmune disorders (e.g., Crohn's disease, rheumatoid arthritis), and organ transplant recipients. Metabolism is catalyzed by S-methyltransferase and nudix hydrolase 15 (NUDT15). [1]

This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential. Keywords: Inflammatory bowel disease, Azathioprine, Mercaptopurine, 6-Thioguanine, Developing countries

Random incorporation into DNA will lead to random mistakes in DNA, which may cause the side effects that we see in the clinic. Eliminating this metabolite from the thiopurine analog could decrease or diminish the side effects seen with these agents. G&H What side effects appear to be related to the DNA-incorporated metabolite?

This review gives a practical overview of thiopurine metabolism, the importance of thiopurine S-methyltransferase testing prior to the start of therapy and the monitoring of thioguanine nucleotide levels while on treatment, guiding a personalised approach to optimising thiopurine therapy.

Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) of unknown etiology, characterized by repeated relapse and remission. The efficacy of thiopurine in IBD was first reported in the late 1960s. Thiopurines ...

Before beginning azathioprine or 6-MP treatment, you will need a blood test called TPMT (thiopurine methyltransferase). This checks your body’s ability to process these medications and helps us choose the right dose for you.

The arena for thiopurine medication has significantly diversified since their introduction and both the on- and the off-label applications for inflammatory and autoimmune diseases are extensive.

This review summarises clinical pharmacological aspects of thiopurines in the treatment of chronic inflammatory bowel disease (IBD). Current knowledge of pharmacogenetically guided dosing is discussed for individualisation of thiopurine therapy, particularly to avoid severe adverse effects.

2021年7月16日 · Low-dose thiopurines combined with allopurinol can be used in hypermethylators and in thiopurine-related hepatotoxicity. The measurement of metabolites could be useful to assess compliance, identify patients at risk of adverse events and also facilitating the management of refractory patients.

Insights into thiopurine metabolism and pharmacodynamics have led to two novel strategies to optimize thiopurine therapy.