Effective long-term solution to therapeutic remission in Inflammatory Bowel Disease: Role of Azathioprine.

Abstract

Azathioprine (AZA) is a well-known immunosuppressant used for many years for its ability to ensure long term disease remission in inflammatory bowel diseases (IBD) at an affordable cost to the public. However, the side effect profile has raised many concerns with numerous investigations into the risk, cause and prevention of these effects. Much of the side effect profile of AZA can be linked to a single nucleotide polymorphism (SNP) in the thiopurine methyltransferase (TPMT) gene which ensures the breakdown and efficacy of AZA. Mutated TPMT alleles result in low or deficient TPMT levels which directly correlate to cytotoxity. This is a review of the role of AZA in the treatment of IBD. Knowing a patient's TPMT status allows the prescribing doctor to make an informed decision about dosage and be more alert to the signs of cytotoxicity. It is essential to include "early warning" SNP testing into common practice to ensure therapeutic efficacy.

• Authors: Lyla Adam, Alisa Phulukdaree, Prashilla Soma
• Journal: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie (Biomed Pharmacother) Vol. 100 Pg. 8-14 (Apr 2018) ISSN: 1950-6007 [Electronic] France
• PMID: 29421584 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Chemical References

• Immunosuppressive Agents
• Methyltransferases
• thiopurine methyltransferase
• Azathioprine

Topics

• Azathioprine (administration & dosage, adverse effects, therapeutic use)
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects, therapeutic use)
• Inflammatory Bowel Diseases (drug therapy, enzymology, immunology)
• Methyltransferases (genetics)
• Polymorphism, Single Nucleotide
• Remission Induction