Risk factors for thiopurine-induced myelosuppression and infections in inflammatory bowel disease patients with a normal TPMT genotype.

Risk factors for thiopurine-induced myelosuppression and infections in inflammatory bowel disease patients with a normal TPMT genotype. Aliment Pharmacol Ther. 2017 Sep 15;: Authors: Broekman MMTJ, Coenen MJH, Wanten GJ, van Marrewijk CJ, Klungel OH, Verbeek ALM, Hooymans PM, Guchelaar HJ, Scheffer H, Derijks LJJ, Wong DR, de Jong DJ Abstract BACKGROUND: Leucopenia is a common side effect in patients treated with thiopurines. Variants in the thiopurine S-methyltransferase (TPMT) gene are the best-known risk factor, but only explain up to 25% of leucopenia cases. AIM: To identify the clinical risk…

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Screening for Epstein-Barr Virus Status and Risk of Hemophagocytic Lymphohistiocytosis in Children With Inflammatory Bowel Disease on Azathioprine.

Screening for Epstein-Barr Virus Status and Risk of Hemophagocytic Lymphohistiocytosis in Children With Inflammatory Bowel Disease on Azathioprine. Gastroenterology. 2017 Sep 04;: Authors: Chapman S, El-Matary W PMID: 28881189 [PubMed – as supplied by publisher] PubMed Link: https://www.ncbi.nlm.nih.gov/pubmed/28881189?dopt=Abstract

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Thiopurines prevented surgical recurrence in patients with Crohn’s disease after intestinal resection: strategy based on risk stratification.

Related Articles Thiopurines prevented surgical recurrence in patients with Crohn’s disease after intestinal resection: strategy based on risk stratification. J Gastroenterol Hepatol. 2017 Aug 14;: Authors: Guo J, Chen BL, Chen ZH, Luo XP, Qiu Y, Zhang SH, Feng R, He Y, Zeng ZR, Song XM, Ben-Horin S, Mao R, Chen MH Abstract BACKGROUND: Thiopurines (TPs) are effective in reducing risk of clinical and endoscopic recurrence in postoperative patients with Crohn’s disease (CD). However, whether TPs could prevent surgical recurrence (SR) remains unknown. AIM: To explore whether TPs could prevent…

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Thiopurines Dosed to a Therapeutic 6-Thioguanine Level in Combination with Adalimumab Are More Effective Than Subtherapeutic Thiopurine-based Combination Therapy or Adalimumab Monotherapy During Induction and Maintenance in Patients with Long-standing Crohn’s Disease.

Thiopurines Dosed to a Therapeutic 6-Thioguanine Level in Combination with Adalimumab Are More Effective Than Subtherapeutic Thiopurine-based Combination Therapy or Adalimumab Monotherapy During Induction and Maintenance in Patients with Long-standing Crohn’s Disease. Inflamm Bowel Dis. 2017 Aug 03;: Authors: Kariyawasam VC, Ward MG, Blaker PA, Patel KV, Goel R, Sanderson JD, Irving PM Abstract BACKGROUND: The benefit of concomitant immunomodulation with adalimumab (ADA) in Crohn’s disease is poorly understood. We aimed to compare ADA monotherapy with combination therapy with thiopurines, stratified by thioguanine nucleotides (TGNs). METHODS: Retrospective observational study of…

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More Dose-dependent Side Effects with Mercaptopurine over Azathioprine in IBD Treatment Due to Relatively Higher Dosing.

More Dose-dependent Side Effects with Mercaptopurine over Azathioprine in IBD Treatment Due to Relatively Higher Dosing. Inflamm Bowel Dis. 2017 Jun 20;: Authors: Broekman MMTJ, Coenen MJH, van Marrewijk CJ, Wanten GJA, Wong DR, Verbeek ALM, Klungel OH, Hooymans PM, Guchelaar HJ, Scheffer H, Derijks LJJ, de Jong DJ, TOPIC Recruitment Team Abstract BACKGROUND: There are substantial global differences in the preference for mercaptopurine (MP) or its prodrug azathioprine (AZA) as first-choice thiopurine to treat inflammatory bowel diseases. Studies comparing both agents are scarce. Our aim was to compare AZA…

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Optimizing Thiopurine Therapy in Inflammatory Bowel Disease Among 2 Real-life Intercept Cohorts: Effect of Allopurinol Comedication?

Optimizing Thiopurine Therapy in Inflammatory Bowel Disease Among 2 Real-life Intercept Cohorts: Effect of Allopurinol Comedication? Inflamm Bowel Dis. 2017 Jun 14;: Authors: Meijer B, Seinen ML, van Egmond R, Bouma G, Mulder CJJ, van Bodegraven AA, de Boer NKH Abstract BACKGROUND: Thiopurines (azathioprine and mercaptopurine) are frequently used immunosuppressive drugs to maintain remission in patients with inflammatory bowel disease. Half of the conventional thiopurine-derivative users have to discontinue treatment within 5 years, mainly because of intolerable adverse events. Over recent years, different strategies to optimize thiopurine treatment were suggested,…

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Thiopurine use associated with reduced B and natural killer cells in inflammatory bowel disease.

Thiopurine use associated with reduced B and natural killer cells in inflammatory bowel disease. World J Gastroenterol. 2017 May 14;23(18):3240-3251 Authors: Lord JD, Shows DM Abstract AIM: To identify which blood and mucosal lymphocyte populations are specifically depleted by thiopurine use in vivo. METHODS: The thiopurines azathioprine and 6-mercaptopurine have been a mainstay of inflammatory bowel disease (IBD) therapy for decades, but their mechanism of action in vivo remains obscure. Although thiopurines are lymphotoxic at high doses, and have been reported to cause T cell apoptosis in vitro, their ability…

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Combined Detection of NUDT15 Variants Could Highly Predict Thiopurine-induced Leukopenia in Chinese Patients with Inflammatory Bowel Disease: A Multicenter Analysis.

Combined Detection of NUDT15 Variants Could Highly Predict Thiopurine-induced Leukopenia in Chinese Patients with Inflammatory Bowel Disease: A Multicenter Analysis. Inflamm Bowel Dis. 2017 May 24;: Authors: Chao K, Wang X, Cao Q, Qian J, Wu K, Zhu X, Yang H, Liang J, Lin L, Huang Z, Zhang Y, Huang Y, Sun Y, Xue X, Huang M, Hu P, Lan P, Gao X Abstract BACKGROUND: NUDT15 c.415C>T was a novel genetic marker confirmed in our center for thiopurine-induced leukopenia in Chinese inflammatory bowel disease (IBD). For validation, a large cohort…

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Azathioprine with Allopurinol: Lower Deoxythioguanosine in DNA and Transcriptome Changes Indicate Mechanistic Differences to Azathioprine Alone.

Related Articles Azathioprine with Allopurinol: Lower Deoxythioguanosine in DNA and Transcriptome Changes Indicate Mechanistic Differences to Azathioprine Alone. Inflamm Bowel Dis. 2017 Apr 27;: Authors: Coulthard SA, Berry P, McGarrity S, McLaughlin S, Ansari A, Redfern CPF Abstract BACKGROUND: Use of azathioprine (AZA) for inflammatory bowel disease is limited by side effects or poor efficacy. Combining low-dose azathioprine with allopurinol (LDAA) bypasses side effects, improves efficacy, and may be appropriate as first-line therapy. We test the hypothesis that standard-dose azathioprine (AZA) and LDAA treatments work by similar mechanisms, using incorporation…

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