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Monitoring 6‐thioguanine nucleotide concentrations in Japanese patients with inflammatory bowel disease
Author(s) -
Andoh Akira,
Tsujikawa Tomoyuki,
Ban Hiromitsu,
Hashimoto Takayoshi,
Bamba Shigeki,
Ogawa Atsuhiro,
Sasaki Masaya,
Saito Yasuharu,
Fujiyama Yoshihide
Publication year - 2008
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2008.05419.x
Subject(s) - medicine , gastroenterology , ulcerative colitis , mercaptopurine , azathioprine , inflammatory bowel disease , crohn's disease , odds ratio , white blood cell , population , disease , environmental health
Background and Aim: There have been no reports on 6‐thioguanine nucleotide (6‐TGN) concentrations in Japanese patients with inflammatory bowel disease (IBD) undergoing azathioprine (AZA) or 6‐mercaptopurine (6‐MP) therapy. The aim of this study was to assess 6‐TGN concentrations in Japanese IBD patients. Methods: Eighty‐three patients with Crohn's disease ( n = 42) and ulcerative colitis ( n = 41) were enrolled. In 69 patients, AZA was prescribed at 50 mg/day, and seven patients were given 75 ( n = 5) or 100 mg/day ( n = 2). 6‐MP was administered at 30 mg/day ( n = 7). The 6‐TGN concentrations were then assayed by high‐performance liquid chromatography. Results: The mean 6‐TGN concentrations of the entire study population ( n = 83) were 277.9 ± 179.8 pmol/8 × 10 8 red blood cells (RBC). The mean 6‐TGN concentrations in those patients with active disease ( n = 38) and those in remission ( n = 45) were 232.9 ± 159.7(mean ± SD) and 342.8 ± 184.6 pmol/8 × 10 8 RBC, respectively ( P < 0.05). The odds ratio of being in remission and having a 6‐TGN value >235 pmol/8 × 10 8 RBC was 2.6 (95% CI 1.05–6.2). A significant inverse correlation was found between the white blood cell (WBC) counts and 6‐TGN concentrations ( r = −0.301, P < 0.05, n = 83); the mean WBC counts of the active patients (6780 ± 2412) were significantly higher than the patients in clinical remission (5468 ± 1920, P < 0.05). Three patients with severe leukopenia and 10 patients with high 6‐TGN concentrations had no thiopurine S‐methyl transferase mutations. Conclusion: The 6‐TGN concentrations in Japanese patients with IBD on low‐dose AZA and 6‐MP therapy were comparable to those reported from Western countries. The monitoring of 6‐TGN concentrations may be helpful for developing a therapeutic strategy for Japanese IBD patients.