Original Article
http://dx.doi.org/10.3349/ymj.2014.55.5.1289 pISSN: 0513-5796, eISSN: 1976-2437
Yonsei Med J 55(5):1289-1296, 2014
Monitoring Thiopurine Metabolites in Korean Pediatric Patients with Inflammatory Bowel Disease Mi Jin Kim,1 Soo Youn Lee,2 and Yon Ho Choe3 Department of Pediatrics, Ilsan Paik Hospital, Inje University College of Medicine, Goyang; Departments of Laboratory Medicine and Genetics and 3Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 1
2
Received: October 28, 2013 Revised: February 13, 2014 Accepted: March 3, 2014 Corresponding author: Dr. Yon Ho Choe, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-3539, Fax: 82-2-3410-0043 E-mail: [email protected] ∙ The authors have no financial conflicts of interest.
Purpose: This study aimed to assess the role of thiopurine S-methyltransferase (TPMT) and 6-thioguanine nucleotide (6-TGN) as predictors of clinical response and side effects to azathioprine (AZA), and estimate the optimal AZA dose in Korean pediatric inflammatory bowel disease (IBD) patients. Materials and Methods: One hundred and nine pediatric IBD patients in whom AZA treatment was required were enrolled. Thiopurine metabolites were monitored since September 2010. Among them, 83 patients who had prescribed AZA for at least 3 months prior to September 2010 were enrolled and followed until October 2011 to evaluate optimal AZA dose, adverse effects and disease activity before and after thiopurine metabolite monitoring. Results: The result of the TPMT genotype was that 102 patients were *1/*1 (wild type), four were *1/*3C, one was *1/*6, one was *1/*16 (heterozygote) and one was *3C/*3C (homozygote). Adverse effects happened in 31 patients pre-metabolite monitoring and in only nine patients post-metabolite monitoring. AZA dose was 1.4±0.31 mg/kg/day before monitoring and 1.1±0.46 mg/kg/day after monitoring (p
http://dx.doi.org/10.3349/ymj.2014.55.5.1289 pISSN: 0513-5796, eISSN: 1976-2437
Yonsei Med J 55(5):1289-1296, 2014
Monitoring Thiopurine Metabolites in Korean Pediatric Patients with Inflammatory Bowel Disease Mi Jin Kim,1 Soo Youn Lee,2 and Yon Ho Choe3 Department of Pediatrics, Ilsan Paik Hospital, Inje University College of Medicine, Goyang; Departments of Laboratory Medicine and Genetics and 3Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 1
2
Received: October 28, 2013 Revised: February 13, 2014 Accepted: March 3, 2014 Corresponding author: Dr. Yon Ho Choe, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-3539, Fax: 82-2-3410-0043 E-mail: [email protected] ∙ The authors have no financial conflicts of interest.
Purpose: This study aimed to assess the role of thiopurine S-methyltransferase (TPMT) and 6-thioguanine nucleotide (6-TGN) as predictors of clinical response and side effects to azathioprine (AZA), and estimate the optimal AZA dose in Korean pediatric inflammatory bowel disease (IBD) patients. Materials and Methods: One hundred and nine pediatric IBD patients in whom AZA treatment was required were enrolled. Thiopurine metabolites were monitored since September 2010. Among them, 83 patients who had prescribed AZA for at least 3 months prior to September 2010 were enrolled and followed until October 2011 to evaluate optimal AZA dose, adverse effects and disease activity before and after thiopurine metabolite monitoring. Results: The result of the TPMT genotype was that 102 patients were *1/*1 (wild type), four were *1/*3C, one was *1/*6, one was *1/*16 (heterozygote) and one was *3C/*3C (homozygote). Adverse effects happened in 31 patients pre-metabolite monitoring and in only nine patients post-metabolite monitoring. AZA dose was 1.4±0.31 mg/kg/day before monitoring and 1.1±0.46 mg/kg/day after monitoring (p
