Prospective study of the effects of concomitant medications on thiopurine metabolism in inflammatory bowel disease
Autor: | Roberto Canaparo, Franco Castagno, Alessandro Lavagna, Sergio D'Antico, Rodolfo Rocca, Elena Ercole, A. Vernetto, L. Crocellà, Marco Daperno, Loredana Serpe, G. P. Zara, C. Rigazio, R. Sostegni, Angelo Pera |
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Rok vydání: | 2009 |
Předmět: |
Adult
Male Drug medicine.medical_specialty Genotype media_common.quotation_subject Polymerase Chain Reaction Inflammatory bowel disease Gastroenterology Young Adult Pharmacokinetics Internal medicine Azathioprine Humans Medicine Drug Interactions Pharmacology (medical) Prospective Studies Mesalamine Prospective cohort study media_common Hepatology Thiopurine methyltransferase biology Mercaptopurine business.industry Anti-Inflammatory Agents Non-Steroidal DNA Metabolism Middle Aged Inflammatory Bowel Diseases medicine.disease Ulcerative colitis Concomitant Multivariate Analysis biology.protein Female business Immunosuppressive Agents |
Zdroj: | Alimentary Pharmacology & Therapeutics. 30:843-853 |
ISSN: | 1365-2036 0269-2813 |
Popis: | Aliment Pharmacol Ther 30, 843–853 Summary Background Thiopurines are increasingly used in the treatment of inflammatory bowel disease (IBD), being the most common immunosuppressive therapy; however, potentially harmful interactions between thiopurines and other drugs (especially 5-aminosalicylic acid, 5-ASA) were described. Aim To explore potential interactions between thiopurines and concomitant medications. Methods A total of 183 consecutive IBD patients were enrolled. Clinical characteristics and concomitant medications were recorded. Thiopurine metabolism was analysed with thiopurine S-methyl transferase (TPMT) genetic variants and enzyme activity assays. Comparisons were carried out with stratification of patients according to clinical characteristics and active treatments. Results Based on TPMT genetics, 95% IBD patients were wild-type homozygous, the remaining being heterozygous. Median TPMT activity was 24.9 U/Hgb g (IQR 20.7–29.5). No difference in TPMT activity was noted according to 5-ASA exposure. IBD patients on thiopurines had higher TPMT activity levels, but no dose-effect was evident. No difference in TPMT activity was observed in 41 (63%) patients co-treated with 5-ASA. In patients on active thiopurines also, 6-TGN and 6-MMP levels were evaluated and no significant difference was observed based on co-medication. TPMT activity was independently associated only with thiopurines dose (P = 0.016). Conclusions Our data suggest the absence of significant interactions between thiopurines and 5-ASA. |
Databáze: | OpenAIRE |
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