ArticleJGH open : an open access journal of gastroenterology and hepatology2017
Thiopurine metabolite level and toxicity in Indians with inflammatory bowel disease.
Article in JGH open : an open access journal of gastroenterology and hepatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 8 citations in OpenAlex.
- Clinical utility of thiopurine metabolite levels in monitoring patients with inflammatory bowel disease: A single-centre retrospective study.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- Therapeutic drug monitoring in inflammatory bowel disease: A practical approach.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Azathioprine-Induced Marrow Suppression in Dermatology Patients - Analysis of 18 Patients.Indian journal of dermatologyArticle
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4 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimA lower dose requirement and higher toxicity of thiopurine is reported in Asian patients with inflammatory bowel disease (IBD) as compared with Caucasian patients. These reports are based on thiopurine methyltransferase measurement studies rather than metabolite estimation.We studied the utility of thiopurine metabolite estimation in Indian patients with IBD and compared dose and toxicity with Asian and Caucasian patients.
methodsIn this prospective study, 6-thioguanine nucleotide (6-TGN) and 6-methylmercaptopurine levels were determined by HPLC in 76 IBD patients treated with thiopurines. The levels were correlated with dose, disease activity, and toxicity. The dose-related metabolite levels and toxicity were compared with Caucasian and Asian patients reported in literature.
resultsOf the 76 patients (32 women, mean age: 35.9 [SD: 14.54] years, 36 Crohn's disease and 40 ulcerative colitis), 1 non-compliant patient had undetectable level of metabolites. Of the 75 patients, 21(28%) had therapeutic level of 6-TGN, 37(49%) had subtherapeutic level and 17(23%) had supratherapeutic level. The 6-methylmercaptopurine levels ranged up to 4971 pmol/8 × 10
conclusionHalf of the patients in this study had low and a quarter had high 6-TGN levels. One-fourth of the patients needed dose modification. The dose-based metabolite levels were comparable and the toxicity was less than that reported in Asian and Caucasian patients.
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