ArticleTherapeutic drug monitoring2017
Pharmacology of Thiopurine Therapy in Inflammatory Bowel Disease and Complete Blood Cell Count Outcomes: A 5-Year Database Study.
Article in Therapeutic drug monitoring, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Blood-test monitoring strategies for patients established on immune-suppressing drugs: a mixed-methods study.Health technology assessment (Winchester, England) · 2026Pooled it
- Pretreatment neutrophil-to-lymphocyte ratio predicts clinical relapse of ulcerative colitis after tacrolimus induction.PloS one · 2019Trial
- Adverse Events Related to Azathioprine Use in Patients With Inflammatory Bowel Disease: A Real-World Cohort Study.Gastroenterology research and practice · 2026Article
- Risk-stratified monitoring for sulfasalazine toxicity: prognostic model development and validation.RMD open · 2024Article
- The drug-survival of low-dose thioguanine in patients with inflammatory bowel disease: a retrospective observational study.Therapeutic advances in gastroenterology · 2024Article
- Risk-stratified monitoring for thiopurine toxicity in immune-mediated inflammatory diseases: prognostic model development, validation, and, health economic evaluation.EClinicalMedicine · 2023Article
- Risk stratified monitoring for methotrexate toxicity in immune mediated inflammatory diseases: prognostic model development and validation using primary care data from the UK.BMJ (Clinical research ed.) · 2023Article
- Article
- Development and validation of a prognostic model for leflunomide discontinuation with abnormal blood tests during long-term treatment: cohort study using data from the Clinical Practice Research Datalink Gold and Aurum.Rheumatology (Oxford, England) · 2022Article
- Thiopurines' Metabolites and Drug Toxicity: A Meta-Analysis.Journal of clinical medicine · 2020Review
- Increased Risk of Liver Cirrhosis during Azathioprine Therapy for Crohn's Disease.Case reports in gastrointestinal medicine · 2020Article
- Biomarkers Predictive of Response to Thiopurine Therapy in Inflammatory Bowel Disease.Frontiers in medicine · 2020Review
- Reduced CD27Frontiers in immunology · 2019Article
- Can We Predict the Toxicity and Response to Thiopurines in Inflammatory Bowel Diseases?Frontiers in medicine · 2019Review
- Biochemical efficacy of tioguanine in autoimmune hepatitis: a retrospective review of practice in the Netherlands.Alimentary pharmacology & therapeutics · 2018Article
- Influence ofWorld journal of gastroenterology · 2018Article
- Impact of thiopurine dose in anti-tumor necrosis factor combination therapy on outcomes in inflammatory bowel disease.Annals of gastroenterologyArticle
Corrections and comments
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThiopurines are the prerequisite for immunomodulation in inflammatory bowel disease (IBD) therapy. When administered in high (oncological) dose, thiopurine metabolites act as purine antagonists, causing DNA-strand breakage and myelotoxicity. In lower IBD dosages, the mode of action is primarily restricted to anti-inflammatory effects. Then, myelosuppression and hepatotoxicity are the most common adverse events of thiopurines. The aim of this study was to assess the effect of thiopurine metabolites on hematologic and hepatic parameters and to determine which patient characteristics are related to generation of thiopurine metabolites.
methodsThe authors scrutinized the therapeutic drug monitoring database of the VU University medical center and subsequently merged this database with the Clinical Laboratory database of our hospital covering the same time period (2010-2015).
resultsThe authors included 940 laboratory findings of 424 unique patients in this study. Concentrations of 6-thioguanine nucleotides (6-TGN) correlated negatively with red blood cell count, white blood cell count, and neutrophil count in both azathioprine (AZA) and mercaptopurine users. There was a positive correlation with mean corpuscular volume. In patients using 6-thioguanine, 6-TGN concentrations correlated positively with white blood cell count. Furthermore, there was an inverse correlation between patient's age and 6-TGN concentrations in patients using AZA or 6-thioguanine, and we observed an inverse correlation between body mass index and 6-TGN concentrations in patients using AZA or mercaptopurine. No relations were observed with liver test abnormalities.
conclusionsThiopurine derivative therapy influenced bone marrow production and the size of red blood cells. Age and body mass index were important pharmacokinetic factors in the generation of 6-TGN.
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