ArticleThe Canadian journal of hospital pharmacy2021
Optimizing Thiopurine Therapy with a Xanthine Oxidase Inhibitor in Patients with Systemic Autoimmune Diseases: A Single-Centre Experience.
Article in The Canadian journal of hospital pharmacy, 2021. 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, 3 citations in OpenAlex.
- A Phase I Study to Evaluate the Pharmacokinetic Drug‒Drug Interaction of HP501, Febuxostat, and Colchicine in Male Chinese Patients with Hyperuricemia.Clinical drug investigation · 2023Trial
- Influence of xanthine oxidase and inosine monophosphate dehydrogenase polymorphisms on 6-mercaptopurine treatment response in pediatric acute lymphoblastic leukemia.Scientific reports · 2025Article
- Dapansutrile in multidisciplinary therapeutic applications: mechanisms and clinical perspectives.Frontiers in pharmacology · 2025Review
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Authors and funding
6 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThiopurines are a mainstay of therapy for autoimmune diseases. However, up to 20% to 30% of patients experience overproduction of the methylated metabolites, known as 6-MMP, to the detriment of the active metabolite, 6-thioguanine nucleotide (6-TGN). These patients, commonly referred to as "shunters", are predisposed to thiopurine resistance and hepatotoxicity. In patients with inflammatory bowel diseases, the combination of thiopurine with a xanthine oxidase inhibitor (XOI) is used to reverse this skewed metabolism and to prevent treatment failure or hepatotoxicity. Data on the use of this strategy for patients with other diseases are limited.
objectivesTo investigate and describe the use of thiopurine-XOI combination therapy in shunters with systemic autoimmune diseases.
methodsShunters treated in the study hospital between January 1, 2005, and December 31, 2015, were identified using the hospital's laboratory database, and clinical data were collected retrospectively. For each patient with optimization of thiopurine therapy, clinical and laboratory data were assessed over a 6-month period.
resultsThirty-four patients were identified as shunters; for 14 of these patients, thiopurine therapy was optimized with an XOI. In these 14 patients, the median dose of azathioprine was reduced from 1.95 to 0.78 mg/kg with combination therapy. In addition, median 6-TGN level increased from 135 to 385 pmol/8 × 10
conclusionOptimizing thiopurine therapy with an XOI may be a safe and effective strategy for patients with systemic autoimmune diseases.
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