ArticleBMC gastroenterology2021
TPMT and NUDT15 polymorphisms in thiopurine induced leucopenia in inflammatory bowel disease: a prospective study from India.
Article in BMC gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 33 citations in OpenAlex.
- Frequency of thiopurine methyltransferase variants and exploratory predictors of azathioprine-induced leukopenia in Saudi patients with inflammatory bowel disease.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026Article
- Decoding genetic divergence: TPMT and NUDT15 polymorphisms in north India mirror Caucasian ancestry.Intestinal research · 2026Article
- Comparison of Azathioprine-Induced Pancreatitis and Gastrointestinal Intolerance in IBD: Role of Demographics, Clinical Variables, and HLA DQA1/DRB1 Alleles.Journal of clinical medicine · 2025Article
- TPMT Genotyping in 1000 Indian Patients: 14-Year Experience from a Tertiary-Care Hospital.EJIFCC · 2025Article
- Difficult to treat and refractory autoimmune hepatitis: Recent advances in pharmacological management.World journal of hepatology · 2025Review
- Review
- Strategies for Enhancing Inflammatory Bowel Disease Care in Pakistan: Bridging Gaps and Building Capacities.Crohn's & colitis 360 · 2024Article
- Uphill battle: Innovation of thiopurine therapy in global inflammatory bowel disease care.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- A Simple, Rapid, and Cost-Effective PCR Procedure for Detection ofJournal of laboratory physicians · 2023Article
- Molecular medicine-based IBD treatment strategies-we take it personally!Frontiers in gastroenterology (Lausanne, Switzerland) · 2023Review
- Personalized medicine to implementation science: Thiopurines set for the leap.JGH open : an open access journal of gastroenterology and hepatology · 2022Article
- Highlights From the 2021 Advances in Inflammatory Bowel Diseases Conference: Commentary.Gastroenterology & hepatology · 2021Article
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10 authors at 1 institution in 1 country.
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Abstract
backgroundPolymorphisms in thiopurine methyltransferase (TPMT) and Nudix hydrolase-15 (NUDT15) have been implicated as the predominant cause of thiopurine induced leukopenia in the Western countries and East Asia respectively. Exact role of these polymorphisms in South Asian population with inflammatory bowel disease (IBD) is uncertain.
methodsWe included consecutive patients with IBD who were initiated on thiopurines at a center in North India. The dosage of thiopurines was titrated using regular monitoring of hemogram and liver function tests. Three TPMT polymorphisms (c.238 G > C, c.460 G > A, and c.719A > G) and one NUDT15 polymorphism (c.415 C > T) were assessed. Comparison regarding incidence of leukopenia and maximum tolerated thiopurine dosage was performed between those with wild polymorphism and those with TPMT and NUDT15 polymorphisms, respectively.
resultsOf the 119 patients (61 males, mean age 36.8 ± 13.5 years), 105 (88.2%) had ulcerative colitis and 14 (11.8%) had Crohn's disease. Leukopenia was noted in 33 (27.7%), gastrointestinal intolerance in 5 (4.2%) and pancreatitis in 2 (1.6%). TPMT polymorphisms were detected amongst five patients of whom 1 developed leukopenia. NUDT15 polymorphism was noted in 13 patients of whom 7 had leukopenia. The odds of developing leukopenia in TPMT polymorphism were non-significant (0.77, 95% CI:0.0822 to 7.2134, P = 0.819) but were significantly higher in those with NUDT15 polymorphism (3.5933, 1.1041 to 11.6951, P value: = 0.0336).
conclusionNUDT15 polymorphism was more frequent than TPMT polymorphisms and was associated with thiopurine induced leukopenia. However, the tested polymorphisms account for only 24.2% of the risk of thiopurine induced leukopenia.
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