Abstract
Background: More than 20% of inflammatory bowel diseases (IBD) patients discontinue thiopurine therapy due to severe adverse drug reactions among which leucopenia is one of the most serious. Thiopurine S-methyltransferase (TPMT) pharmacogenetics has been proven effective for optimizing azathioprine/mercaptopurine safety. Nevertheless, TPMT screening is used in clinical practice on a very limited scale. The aim of our study was to assess whether pre-treatment TPMT genotype-based dosing reduces the occurrence of leucopenia and whether this strategy is cost-effective. Methods: We performed a randomized trial in thiopurine naïve IBD patients starting on thiopurine treatment [the Dutch “Thiopurine response Optimization by Pharmacogenetic testing in Inflammatory bowel disease Clinics” (TOPIC) study (ClinicalTrials.gov: NCT00521950)]. Patients were randomly assigned to pre-treatment screening for three common variants in TPMT (TPMT∗2, ∗3A and ∗3C) or standard thiopurine treatment. Patients heterozygous for a TPMT variant received 50% of the standard thiopurine dose, patients homozygous for the tested variants 0-10%. We compared pre-treatment genotyped patients with patients receiving standard dose for the occurrence of leucopenia (leucocyte count
Original language | English |
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Article number | OP006 |
Pages (from-to) | 4 |
Number of pages | 1 |
Journal | Journal of Crohn's & Colitis |
Volume | 8 |
DOIs | |
Publication status | Published - 1 Feb 2014 |
Keywords
- mercaptopurine
- thiopurine methyltransferase
- genotype
- leukopenia
- cost control
- patient
- human
- Netherlands
- colitis
- screening
- risk
- inflammatory bowel disease
- control group
- therapy
- cost effectiveness analysis
- leukocyte count
- hospital
- clinical practice
- safety
- pharmacogenetics
- arm
- genetic variability
- adverse drug reaction