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Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients
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 d...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723288/ https://www.ncbi.nlm.nih.gov/pubmed/31387318 http://dx.doi.org/10.3390/medicina55080441 |
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author | Ribaldone, Davide Giuseppe Adriani, Alessandro Caviglia, Gian Paolo De Nicolò, Amedeo Agnesod, Danilo Simiele, Marco Riganò, Danila Pellicano, Rinaldo Canaparo, Roberto Di Perri, Giovanni D’Avolio, Antonio Luzza, Francesco Abenavoli, Ludovico Saracco, Giorgio Maria Astegiano, Marco |
author_facet | Ribaldone, Davide Giuseppe Adriani, Alessandro Caviglia, Gian Paolo De Nicolò, Amedeo Agnesod, Danilo Simiele, Marco Riganò, Danila Pellicano, Rinaldo Canaparo, Roberto Di Perri, Giovanni D’Avolio, Antonio Luzza, Francesco Abenavoli, Ludovico Saracco, Giorgio Maria Astegiano, Marco |
author_sort | Ribaldone, Davide Giuseppe |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6723288 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-67232882019-09-10 Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients Ribaldone, Davide Giuseppe Adriani, Alessandro Caviglia, Gian Paolo De Nicolò, Amedeo Agnesod, Danilo Simiele, Marco Riganò, Danila Pellicano, Rinaldo Canaparo, Roberto Di Perri, Giovanni D’Avolio, Antonio Luzza, Francesco Abenavoli, Ludovico Saracco, Giorgio Maria Astegiano, Marco Medicina (Kaunas) Article 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. MDPI 2019-08-05 /pmc/articles/PMC6723288/ /pubmed/31387318 http://dx.doi.org/10.3390/medicina55080441 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ribaldone, Davide Giuseppe Adriani, Alessandro Caviglia, Gian Paolo De Nicolò, Amedeo Agnesod, Danilo Simiele, Marco Riganò, Danila Pellicano, Rinaldo Canaparo, Roberto Di Perri, Giovanni D’Avolio, Antonio Luzza, Francesco Abenavoli, Ludovico Saracco, Giorgio Maria Astegiano, Marco Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients |
title | Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients |
title_full | Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients |
title_fullStr | Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients |
title_full_unstemmed | Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients |
title_short | Correlation between Thiopurine S-Methyltransferase Genotype and Adverse Events in Inflammatory Bowel Disease Patients |
title_sort | correlation between thiopurine s-methyltransferase genotype and adverse events in inflammatory bowel disease patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723288/ https://www.ncbi.nlm.nih.gov/pubmed/31387318 http://dx.doi.org/10.3390/medicina55080441 |
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