Clinical Pharmacogenetics Implementation Consortium guidelines for thiopurine methyltransferase genotype and thiopurine dosing

M V Relling, E E Gardner, W J Sandborn, K Schmiegelow, C-H Pui, S W Yee, Paul C. Stein, Maria Berrocal Carrillo, W E Evans, T E Klein, Clinical Pharmacogenetics Implementation Consortium

    403 Citationer (Scopus)

    Abstract

    Thiopurine methyltransferase (TPMT) activity exhibits monogenic co-dominant inheritance, with ethnic differences in the frequency of occurrence of variant alleles. With conventional thiopurine doses, homozygous TPMT-deficient patients (~1 in 178 to 1 in 3,736 individuals with two nonfunctional TPMT alleles) experience severe myelosuppression, 30-60% of individuals who are heterozygotes (~3-14% of the population) show moderate toxicity, and homozygous wild-type individuals (~86-97% of the population) show lower active thioguanine nucleolides and less myelosuppression. We provide dosing recommendations (updates at http://www.pharmgkb.org) for azathioprine, mercaptopurine (MP), and thioguanine based on TPMT genotype.
    OriginalsprogEngelsk
    TidsskriftClinical Pharmacology and Therapeutics
    Vol/bind89
    Udgave nummer3
    Sider (fra-til)387-91
    Antal sider5
    ISSN0009-9236
    DOI
    StatusUdgivet - mar. 2011

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