Thiopurine methyltransferase enzyme activity determination (Part 1)
Azathioprine (AZA) and 6-mercaptopurine (6-MP) are purine analogues that interfere with nucleic acid metabolism and cell proliferation, and both drugs have immunosuppressive properties. Both have been shown to be effective for the induction and maintenance of remission in cases of corticosteroid-dependent or corticosteroid-resistant inflammatory bowel disease (IBD) and in the management of fistulizing Crohn’s disease (CD). A meta-analysis has shown that 56% of patients with active CD treated with AZA/6-MP experienced either improvement in their disease state or induction of remission. The same analysis showed that 67% of CD patients with quiescent disease who were treated with AZA/6-MP maintained remission. However, AZA/6-MP use is limited by its short- and long-term toxicities . Adverse effects caused by AZA/6-MP include leukopenia, bone marrow suppression, hepatotoxicity, pancreatitis and nonspecific side effects such as nausea, vomiting, skin rash, myalgia and fever. The major limiting side effect of AZA/6-MP is myelosuppression. Approximately 10% of patients with IBD who are treated with AZA/6-MP develop side effects . Concern over acute myelosuppression and short-term toxicity frequently leads to the initiation of nontherapeutic dosing regimens and frequent monitoring tests and visits. After reading all about the health problem you have, you would probably like to learn more about the treatment options. You can visit the my canadian pharmacy.com to find any medications you need, because it has a selection wide enough for every patient to find exactly what’s required.