Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients. in Medicina (Kaunas, Lithuania) / Medicina (Kaunas). 2019 Aug 5;55(8):441. doi: 10.3390/medicina55080441.
2019
AOU Città della Salute di Torino
ASL Città di Torino
Tipo pubblicazione
Journal Article
Autori/Collaboratori (14)Vedi tutti...
Luzza F
Department of Health Sciences, University "Magna Graecia", viale Europa, 88100 Catanzaro, Italy.
D'Avolio A
Department of Medical Sciences, Unit of Infectious Diseases, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy.
Perri GD
Department of Medical Sciences, Unit of Infectious Diseases, University of Turin, Amedeo di Savoia Hospital, 10149 Turin, Italy.
et alii...
Abstract
Background and Objectives: In patients with inflammatory bowel diseases (IBD), the use of azathioprine results in adverse events at a rate of 5% to 20%. The aim of the study was to assess a possible correlation between genetic variability of the enzyme thiopurine S-methyltransferase (TPMT) and the development of toxicity to azathioprine. Materials and Methods: A retrospective, single center, blind, case-control study was conducted on 200 IBD patients, of whom 60 cases suspended azathioprine due to toxicity (leukopenia, pancreatitis, hepatitis, and nausea or vomiting), and 140 controls continued treatment with the drug without adverse events. Results: In the entire cohort, only 8 cases of heterozygous mutations of TPMT were observed, corresponding to 4% mutated haplotype rate, much lower than that reported in literature (close to 10%). No homozygous mutation was found. Regarding the TPMT allelic variants, we did not find any statistically significant difference between patients who tolerated azathioprine and those who suffered from adverse events. (OR = 0.77, 95% CI = 0.08-7.72; p = 0.82). Conclusions: According to our study, in IBD patients, the search for TPMT gene mutations before starting treatment with azathioprine is not helpful in predicting the occurrence of adverse events. Importantly, patients with allelic variants should not be denied the therapeutic option of azathioprine, as they may tolerate this drug.
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PMID : 31387318
DOI : 10.3390/medicina55080441
Keywords
ulcerative colitis; small intestine; Crohn’s disease; Middle Aged; Methyltransferases/adverse effects/analysis/blood/genetics; Male; Inflammatory Bowel Diseases/complications/drug therapy/genetics; Immunosuppressive Agents/adverse effects/therapeutic use; Genotype; Humans; Female; Azathioprine/adverse effects/therapeutic use; Aged; Adult; Adolescent; large intestine; inflammatory bowel disease;