BACKGROUND Thiopurines are an effective treatment for moderate to severe inflammatory bowel disease [IBD] and can be used safely in pregnancy. Combining allopurinol with a lower dose of thiopurine can improve clinical efficacy and bypass some adverse reactions associated with thiopurine monotherapy. Data on allopurinol in pregnancy are scarce. We report on a total of 13 cases where thiopurine a...

KK Thiopurines are slow-acting drugs, taking up to 6 months to reach a therapeutic effect. They can be used by themselves as monotherapy or in combination with other therapies. If they are tolerated as monotherapy and if remission of inflammatory bowel disease (IBD) is achieved, then they are good choices for long-term maintenance therapy. Studies have shown that discontinuing therapy results i...

Currently, there are very few guidelines linking the results of pharmacogenetic tests to specific therapeutic recommendations. Therefore, the Royal Dutch Association for the Advancement of Pharmacy established the Pharmacogenetics Working Group with the objective of developing pharmacogenetics-based therapeutic (dose) recommendations. After systematic review of the literature, recommendations w...

Thiopurine methyltransferase (TPMT) catalyzes S-methylation of thiopurine drugs such as 6-mercaptopurine. Large variations in levels of TPMT activity in human tissue can result from a common genetic polymorphism with a series of alleles for low activity. This polymorphism is an important factor responsible for large individual variations in thiopurine toxicity and therapeutic efficacy. We now r...

Received: 22/Jul/2008, Accepted: 8/Mar/2009 Objective: Thiopurine S-methyltransferase (TPMT) catalyses the S-methylation of thiopurine drugs. Low activity phenotypes are correlated with several mutations in the TPMT gene and adverse drug reactions. The molecular basis for dissimilar enzymatic activity of TPMT has been established in Caucasians, African-Americans and Southwest Asians, but it rem...

Up to approximately 40% to 50% of patients discontinue thiopurine therapy during the course of inflammatory bowel disease (IBD). We investigated the role of the metabolite thiopurine in IBD treatment. This was a prospective study. IBD patients receiving azathioprine (AZA) were prospectively included. Thiopurine methyltransferase (TPMT) genotypes were examined before therapy, and thiopurine meta...

Acute lymphoblastic leukemia (ALL) is a malignant transformation and proliferation of lymphoid progenitor cells in bone marrow and blood, which is mainly found in children. Thiopurine methyltransferase (TPMT) is a thiopurine drug metabolizer enzyme that is prescribed for the treatment of ALL. Several single nucleotide polymorphisms in the TPMT gene have been reported to be associated with the d...

Pharmacogenetics deals with inherited differences in the response to drugs. The best-recognized examples are genetic polymorphisms of drug-metabolizing enzymes, which affect about 30% of all drugs. Loss of function of thiopurine S-methyltransferase (TPMT) results in severe and life-threatening hematopoietic toxicity if patients receive standard doses of mercaptopurine and azathioprine. Gene dup...

Abstract Background Pregnant women with Inflammatory Bowel Disease (IBD) continue thiopurines to maintain remission. Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder pregnancy, often causing distressing maternal symptoms and potential implications for outcome. Case studies have reported treatment-resistant intrahepatic in thiopurine-exposed IBD pregnancies. We aimed...