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Titolo:
6-mercaptopurine metabolite levels in children with inflammatory bowel disease
Autore:
Gupta, P; Gokhale, R; Kirschner, BS;
Indirizzi:
Univ Chicago, Childrens Hosp, Dept Pediat, Sect Pediat Gastroenterol Hepatol & Nutr, Chicago, IL 60637 USA Univ Chicago Chicago IL USA 60637 l Hepatol & Nutr, Chicago, IL 60637 USA
Titolo Testata:
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
fascicolo: 4, volume: 33, anno: 2001,
pagine: 450 - 454
SICI:
0277-2116(200110)33:4<450:6MLICW>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CROHNS-DISEASE; PEDIATRIC-PATIENTS; LONG-TERM; AZATHIOPRINE; THERAPY; TOXICITY;
Keywords:
inflammatory bowel disease; Crohn disease; 6-mercaptopurine; 6-thioguanine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Gupta, P Univ Chicago, Childrens Hosp, Dept Pediat, Sect Pediat Gastroenterol Hepatol & Nutr, 5839 S Maryland Ave,MC 4065, Chicago, IL 60637 USA UnivChicago 5839 S Maryland Ave,MC 4065 Chicago IL USA 60637 USA
Citazione:
P. Gupta et al., "6-mercaptopurine metabolite levels in children with inflammatory bowel disease", J PED GASTR, 33(4), 2001, pp. 450-454

Abstract

Objectives: Some authors suggest that efficacy of 6-mercaptopurine (6-MP) in patients with inflammatory bowel disease correlates with circulating 6-thioguanine (6-TG) levels more than 235 pmol/8 x 10(8) red blood cells. The authors evaluated the relation between 6-MP metabolite levels and disease activity in children and adolescents with inflammatory bowel disease. Methods: Clinical status and hematologic and hepatic parameters were determined in 101 children with inflammatory bowel diseasefrom a single center and compared with 6-MP metabolite levels. Results: There was a trend for higher 6-TG levels among patients in remission than among those with active disease (217 vs. 173); however the difference was not statistically significant (P = 0.09). The likelihood of therapeutic response did not increase significantly at 6-TG levels greater than 235 pmol/8 x 108 red blood cells (odds ratio 1.7; P = 0.1). In the current study, 58% of patients in remission had 6-TG levels less than 235. However, serial measurements of 6-MP metabolite levels in 50 patients with active disease showed that increasing 6-TG levels correlated significantly with disease remission in patients followed up longitudinally (P = 0.04). Leukopenia was significantly associated with high 6-TG levels (P = 0.03) but not with clinical response (P = 0.2). Conclusions: These data suggest that the target range of 6-TG levels previously described by others did not apply to 58% of the pediatric patients with IBD in remission. However, serial monitoring of 6-MP metabolite levels in individual patients with active disease should allow dose escalation and induction of remission while minimizing the risk of toxicity.

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Documento generato il 14/07/20 alle ore 13:15:30