Exposure to Azathioprine Metabolites and Clinical Outcome in Indian Patients with Crohn’s Disease

Aim: To determine the concentration of 6-thioguanine nucleotide (6-TGN) and 6-methylmercaptopurine (6-MMP), interpatient variability, relationship with disease activity in patients Chron’s on long-term stable doses azathioprine (AZA). Methods: This is a prospective, tertiary care single-center hospital study adult treated AZA. The quantification phenotypic thiopurine methyltransferase enzyme red blood cells estimation 6-TGN 6-MMP whole was performed using HPLC-UV detector method. A clinical response categorized as remission (Harvey-Bradshaw Index [HBI] < 5) or improvement (drop from baseline at least three points HBI) based HBI. Exposure to metabolite concentrations AZA treatment observed. Results: Study analysis included 30 who were initiated AZA, they followed up an their outcome. At six months, 93% ( n = 28) continued be had improvement. All achieved disease. Only two developed adverse effects such joint pain thrombocytopenia. Conclusion: safe effective therapy managing when administered after determining phenotype dose optimization therapeutic drug monitoring 6-MMP.