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Booth RA, Ansari MT, Tricco AC, et al. Assessment of Thiopurine Methyltransferase Activity in Patients Prescribed Azathioprine or Other Thiopurine-Based Drugs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2010 Dec. (Evidence Reports/Technology Assessments, No. 196.)

Cover of Assessment of Thiopurine Methyltransferase Activity in Patients Prescribed Azathioprine or Other Thiopurine-Based Drugs

Assessment of Thiopurine Methyltransferase Activity in Patients Prescribed Azathioprine or Other Thiopurine-Based Drugs.

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Appendix CEvidence Tables

Additional data are presented here for Key Questions 1b, 1c, 2, 3a, 3b, 3c and 4 Reference list is provided at the end of the document

Key Question 1b. Within and between laboratory precision and reproducibility of enzymatic measurement of TPMT and determination of TPMT allelic polymorphisms

Table C-1. KQ 1b: Precision and reproducibility of TPMT status determinations

Key Question 4. For patients with chronic autoimmune disease, costs of TPMT testing, and treating drug-associated complications

Table C-26. KQ 4: Costs of TPMT testing

Table C-27. KQ 4: Costs of treating azathioprine-associated complications

References

1.
Jacqz-Aigrain E, Bessa E, Medard Y, et al. Thiopurine methyltransferase activity in a French population: h.p.l.c. assay conditions and effects of drugs and inhibitors. British Journal of Clinical Pharmacology. 1994 Jul;38(1):1–8. [PMC free article: PMC1364830] [PubMed: 7946931]
2.
Lennard L, Singleton HJ. High-performance liquid chromatographic assay of human red blood cell thiopurine methyltransferase activity. Journal of Chromatography B: Biomedical Applications. 1994 Nov 4;661(1):25–33. [PubMed: 7866549]
3.
Lennard L, Chew TS, Lilleyman JS. Human thiopurine methyltransferase activity varies with red blood cell age. British Journal of Clinical Pharmacology. 2001 Nov;52(5):539–46. [PMC free article: PMC2014613] [PubMed: 11736862]
4.
Weinshilboum RM, Raymond FA, Pazmino PA. Human erythrocyte thiopurine methyltransferase: radiochemical microassay and biochemical properties. Clinica Chimica Acta. 1978 May 2;85(3):323–33. [PubMed: 657528]
5.
Indjova D, Shipkova M, Atanasova S, et al. Determination of thiopurine methyltransferase phenotype in isolated human erythrocytes using a new simple nonradioactive HPLC method. Ther Drug Monit. 2003 Oct;25(5):637–44. [PubMed: 14508388]
6.
Shipkova M, Niedmann PD, Armstrong VW, et al. Determination of thiopurine methyltransferase activity in isolated human erythrocytes does not reflect putative in vivo enzyme inhibition by sulfasalazine. Clin Chem. 2004 Feb;50(2):438–41. [PubMed: 14752016]
7.
Zhang LR, Song DK, Zhang W, et al. Efficient screening method of the thiopurine methyltransferase polymorphisms for patients considering taking thiopurine drugs in a Chinese Han population in Henan Province (central China). Clinica Chimica Acta. 2007 Feb;376(1–2):45–51. [PubMed: 16952345]
8.
Indjova D, Atanasova S, Shipkova M, et al. Phenotypic and genotypic analysis of thiopurine s-methyltransferase polymorphism in the bulgarian population. Ther Drug Monit. 2003 Oct;25(5):631–6. [PubMed: 14508387]
9.
Anglicheau D, Sanquer S, Loriot MA, et al. Thiopurine methyltransferase activity: new conditions for reversed-phase high-performance liquid chromatographic assay without extraction and genotypic-phenotypic correlation. Journal of Chromatography B: Analytical Technologies in the Biomedical & Life Sciences. 2002 Jun 25;773(2):119–27. [PubMed: 12031837]
10.
Dervieux T, Medard Y, Verpillat P, et al. Possible implication of thiopurine S-methyltransferase in occurrence of infectious episodes during maintenance therapy for childhood lymphoblastic leukemia with mercaptopurine. Leukemia. 2001 Nov;15(11):1706–12. [PubMed: 11681411]
11.
Dervieux T, Medard Y, Baudouin V, et al. Thiopurine methyltransferase activity and its relationship to the occurrence of rejection episodes in paediatric renal transplant recipients treated with azathioprine. British Journal of Clinical Pharmacology. 1999 Dec;48(6):793–800. [PMC free article: PMC2014314] [PubMed: 10594482]
12.
Medard Y, Nafa S, Jacqz-Aigrain E. Thiopurine methyltransferase activity: new high-performance liquid chromatographic assay conditions. Journal of Chromatography. 1997 Oct 24 [PubMed: 9390740]
B, Biomedical Sciences & Applications. 700(1–2):275–7. [PubMed: 9390740]
13.
Menor C, Fueyo JA, Escribano O, et al. Determination of thiopurine methyltransferase activity in human erythrocytes by high-performance liquid chromatography: comparison with the radiochemical method. Ther Drug Monit. 2001 Oct;23(5):536–41. [PubMed: 11591900]
14.
Ganiere-Monteil C, Pineau A, Kergueris MF, et al. Thiopurine methyl transferase activity: new extraction conditions for high-performance liquid chromatographic assay. Journal of Chromatography B: Biomedical Sciences & Applications. 1999 Apr 30;727(1–2):235–9. [PubMed: 10360443]
15.
Escousse A, Guedon F, Mounie J, et al. 6-Mercaptopurine pharmacokinetics after use of azathioprine in renal transplant recipients with intermediate or high thiopurine methyl transferase activity phenotype. J Pharm Pharmacol. 1998 Nov;50(11):1261–6. [PubMed: 9877312]
16.
Whalen CE, Tamary H, Greenberg M, et al. Analysis of 6-mercaptopurine in serum or plasma using high performance liquid chromatography. Ther Drug Monit. 1985;7(3):315–20. [PubMed: 4049471]
17.
Johnson-Davis K, Juenke J, Pickering J, et al. An enzymatic assay used to identify patients with low thiopurine methyltransferase (TPMT) activity. Clin Chem. 2008;54
18.
Khalil MN, Erb N, Khalil PN, et al. Interference free and simplyfied liquid chromatography-based determination of thiopurine S-methyltransferase activity in erythrocytes.[erratum appears in J Chromatogr B Analyt Technol Biomed Life Sci. 2005 Sep 25;824(1–2):348–50] Journal of Chromatography B: Analytical Technologies in the Biomedical & Life Sciences. 2005 Jul 5;821(1):105–11. [PubMed: 15897017]
19.
Ganiere-Monteil C, Medard Y, Lejus C, et al. Phenotype and genotype for thiopurine methyltransferase activity in the French Caucasian population: impact of age. Eur J Clin Pharmacol. 2004 Apr;60(2):89–96. [PubMed: 15022030]
20.
Zhang B, Xu X, Zeng X, et al. Correlation of thiopurine methyltransferase activity and 6-thioguanine nucleotide concentration in Han Chinese patients treated with azathioprine 25 to 100 mg: A 1-year, single-center, prospective study. Curr Therap Res - Clin Experiment. 2006;67(4):270–82.
21.
Keizer-Garritsen JJ, Brouwer C, Lambooy LH, et al. Measurement of thiopurine S-methyltransferase activity in human blood samples based on high-performance liquid chromatography: reference values in erythrocytes from children. Ann Clin Biochem. 2003 Jan;40(Pt 1):86–93. [PubMed: 12542916]
22.
Oselin K, Anier K, Tamm R, et al. Determination of thiopurine S-methyltransferase (TPMT) activity by comparing various normalization factors: reference values for Estonian population using HPLC-UV assay. Journal of Chromatography B: Analytical Technologies in the Biomedical & Life Sciences. 2006 Apr 13;834(1–2):77–83. [PubMed: 16517227]
23.
Kroplin T, Weyer N, Gutsche S, et al. Thiopurine S-methyltransferase activity in human erythrocytes: a new HPLC method using 6-thioguanine as substrate. Eur J Clin Pharmacol. 1998 May;54(3):265–71. [PubMed: 9681671]
24.
Lentz JJ, Cunnigham J, Winland M, et al. Performance evaluation of a thiopurine methyltransferase (TPMT) enzyme activity assay by reversed-phase HPLC. Am J Gastroenterol. 2000;95(9)
25.
Ford L, Graham V, Berg J. Whole-blood thiopurine S-methyltransferase activity with genotype concordance: a new, simplified phenotyping assay. Ann Clin Biochem. 2006 Sep;43(Pt 5):354–60. [PubMed: 17036413]
26.
Ford LT, Cooper SC, Lewis MJ, et al. Reference intervals for thiopurine S-methyltransferase activity in red blood cells using 6-thioguanine as substrate and rapid non-extraction liquid chromatography.[see comment] Ann Clin Biochem. 2004 Jul;41(Pt 4):303–8. [PubMed: 15298742]
27.
Decaux G, Horsmans Y, Houssiau F, et al. High 6-thioguanine nucleotide levels and low thiopurine methyltransferase activity in patients with lupus erythematosus treated with azathioprine. Am J Therapeut. 2001 May;8(3):147–50. [PubMed: 11344381]
28.
Ansari A, Arenas M, Greenfield SM, et al. Prospective evaluation of the pharmacogenetics of azathioprine in the treatment of inflammatory bowel disease. Aliment Pharmacol Ther. 2008 Oct 15;28(8):973–83. [PubMed: 18616518]
29.
Ansari A, Hassan C, Duley J, et al. Thiopurine methyltransferase activity and the use of azathioprine in inflammatory bowel disease. Aliment Pharmacol Ther. 2002 Oct;16(10):1743–50. [PubMed: 12269967]
30.
Gardiner SJ, Gearry RB, Begg EJ, et al. Thiopurine dose in intermediate and normal metabolizers of thiopurine methyltransferase may differ three-fold. Clin Gastroenterol Hepatol. 2008 Jun;6(6):654–60. [PubMed: 18467186]
31.
Haglund S, Lindqvist M, Almer S, et al. Pyrosequencing of TPMT alleles in a general Swedish population and in patients with inflammatory bowel disease.[erratum appears in Clin Chem. 2004 Apr;50(4):788] Clin Chem. 2004 Feb;50(2):288–95. [PubMed: 14656901]
32.
Hindorf U, Lindqvist M, Hildebrand H, et al. Adverse events leading to modification of therapy in a large cohort of patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2006 Jul 15;24(2):331–42. [PubMed: 16842460]
33.
Hindorf U, Lyrenas E, Nilsson A, et al. Monitoring of long-term thiopurine therapy among adults with inflammatory bowel disease. Scand J Gastroenterol Suppl. 2004 Nov;39(11):1105–12. [PubMed: 15545169]
34.
Langley PG, Underhill J, Tredger JM, et al. Thiopurine methyltransferase phenotype and genotype in relation to azathioprine therapy in autoimmune hepatitis. J Hepatol. 2002 Oct;37(4):441–7. [PubMed: 12217596]
35.
Lindqvist M, Hindorf U, Almer S, et al. No induction of thiopurine methyltransferase during thiopurine treatment in inflammatory bowel disease. Nucleosides Nucleotides Nucleic Acids. 2006;25(9–11):1033–7. [PubMed: 17065060]
36.
Marinaki AM, Arenas M, Khan ZH, et al. Genetic determinants of the thiopurine methyltransferase intermediate activity phenotype in British Asians and Caucasians. Pharmacogenetics. 2003 Feb;13(2):97–105. [PubMed: 12563179]
37.
Okada Y, Nakamura K, Kodama T, et al. Thiopurine methyltransferase genotype and phenotype status in Japanese patients with systemic lupus erythematosus. Biol Pharm Bull. 2005 Nov;28(11):2117–9. [PubMed: 16272700]
38.
Schwab M, Schaffeler E, Marx C, et al. Azathioprine therapy and adverse drug reactions in patients with inflammatory bowel disease: impact of thiopurine S-methyltransferase polymorphism.[see comment] Pharmacogenetics. 2002 Aug;12(6):429–36. [PubMed: 12172211]
39.
Snow JL, Gibson LE. The role of genetic variation in thiopurine methyltransferase activity and the efficacy and/or side effects of azathioprine therapy in dermatologic patients.[see comment] Arch Dermatol. 1995 Feb;131(2):193–7. [PubMed: 7857117]
40.
Stassen PM, Derks RP, Kallenberg CG, et al. Thiopurinemethyltransferase (TPMT) genotype and TPMT activity in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis: relation to azathioprine maintenance treatment and adverse effects. Ann Rheum Dis. 2009 May;68(5):758–9. [PubMed: 19366895]
41.
Stocco G, Martelossi S, Barabino A, et al. TPMT genotype and the use of thiopurines in paediatric inflammatory bowel disease. Dig Liver Dis. 2005 Dec;37(12):940–5. [PubMed: 16202677]
42.
Stocco G, Martelossi S, Decorti G, et al. Pharmacogenetics of thiopurines: Can posology be guided by laboratory data. Radiol Oncol. 2004;38(2):101–9. +157.
43.
von Ahsen N, Armstrong VW, Behrens C, et al. Association of inosine triphosphatase 94C>A and thiopurine S-methyltransferase deficiency with adverse events and study drop-outs under azathioprine therapy in a prospective Crohn disease study.[erratum appears in Clin Chem. 2006 Aug;52(8):1628 Note: Schutz, Ekkehard [added]] Clin Chem. 2005 Dec;51(12):2282–8. [PubMed: 16214825]
44.
Winter JW, Gaffney D, Shapiro D, et al. Assessment of thiopurine methyltransferase enzyme activity is superior to genotype in predicting myelosuppression following azathioprine therapy in patients with inflammatory bowel disease.[see comment] Aliment Pharmacol Ther. 2007 May 1;25(9):1069–77. [PubMed: 17439508]
45.
Newman W, Payne K, Tricker K, Roberts S, Fargher E, Pushpakom S, Alder J, Sidgwick G, Payne D, Elliott R, et al. A pragmatic randomised controlled trial of thiopurine methyltransferase (TPMT) genotyping in the managment of patients, prior to azathioprine treatment: The TARGET study[Draft] 2010. Unpublished work. [PubMed: 21692613]
46.
Hindorf U, Jahed K, Bergquist A, et al. Characterisation and utility of thiopurine methyltransferase and thiopurine metabolite measurements in autoimmune hepatitis. J Hepatol. 2010;52(1):106–11. [PubMed: 19906459]
47.
Banerjee S, Bishop WP. Evolution of thiopurine use in pediatric inflammatory bowel disease in an academic center.[see comment] J Pediatr Gastroenterol Nutr. 2006 Sep;43(3):324–30. [PubMed: 16954954]
48.
Czaja AJ, Carpenter HA. Thiopurine methyltransferase deficiency and azathioprine intolerance in autoimmune hepatitis. Dig Dis Sci. 2006 May;51(5):968–75. [PubMed: 16773433]
49.
Firooz A, Ghandi N, Hallaji Z, et al. Role of thiopurine methyltransferase activity in the safety and efficacy of azathioprine in the treatment of pemphigus vulgaris. Arch Dermatol. 2008 Sep;144(9):1143–7. [PubMed: 18794458]
50.
Gisbert JP, Nino P, Rodrigo L, et al. Thiopurine methyltransferase (TPMT) activity and adverse effects of azathioprine in inflammatory bowel disease: long-term follow-up study of 394 patients. Am J Gastroenterol. 2006 Dec;101(12):2769–76. [PubMed: 17026564]
51.
Kader HA, Wenner WJ Jr, Telega GW, et al. Normal thiopurine methyltransferase levels do not eliminate 6-mercaptopurine or azathioprine toxicity in children with inflammatory bowel disease. J Clin Gastroenterol. 2000 Jun;30(4):409–13. [PubMed: 10875470]
52.
Lennard L, Van Loon JA, Weinshilboum RM. Pharmacogenetics of acute azathioprine toxicity: relationship to thiopurine methyltransferase genetic polymorphism. Clin Pharmacol Ther. 1989 Aug;46(2):149–54. [PubMed: 2758725]
53.
Schedel J, Godde A, Schutz E, et al. Impact of thiopurine methyltransferase activity and 6-thioguanine nucleotide concentrations in patients with chronic inflammatory diseases. Ann N Y Acad Sci. 2006 Jun;1069:477–91. [PubMed: 16855176]
54.
Shah JA, Edwards CM, Probert CS. Should azathioprine and 5-aminosalicylates be coprescribed in inflammatory bowel disease?: an audit of adverse events and outcome. Eur J Gastroenterol Hepatol. 2008 Mar;20(3):169–73. [PubMed: 18301295]
55.
Stolk JN, Boerbooms AM, De Abreu RA, et al. Reduced thiopurine methyltransferase activity and development of side effects of azathioprine treatment in patients with rheumatoid arthritis. Arthritis Rheum. 1998 Oct;41(10):1858–66. [PubMed: 9778228]
56.
Bezier M, Reguiai Z, Vitry F, et al. Thiopurine S-methyltransferase genotypic analysis in autoimmune bullous diseases. European Journal of Dermatology. 2008 Sep;18(5):512–7. [PubMed: 18693152]
57.
Black AJ, McLeod HL, Capell HA, et al. Thiopurine methyltransferase genotype predicts therapy-limiting severe toxicity from azathioprine. Ann Intern Med. 1998 Nov 1;129(9):716–8. [PubMed: 9841604]
58.
Corominas H, Domenech M, Laiz A, et al. Is thiopurine methyltransferase genetic polymorphism a major factor for withdrawal of azathioprine in rheumatoid arthritis patients? Rheumatology. 2003 Jan;42(1):40–5. [PubMed: 12509611]
59.
De RL, Van Dieren JM, Van Deventer HJ, et al. Pharmacogenetics of thiopurine therapy in paediatric IBD patients. Aliment Pharmacol Ther. 2006 Apr 15;23(8):1137–41. [PubMed: 16611274]
60.
Derijks LJ, Gilissen LP, Engels LG, et al. Pharmacokinetics of 6-mercaptopurine in patients with inflammatory bowel disease: implications for therapy. Ther Drug Monit. 2004 Jun;26(3):311–8. [PubMed: 15167634]
61.
Dubinsky MC, Lamothe S, Yang HY, et al. Pharmacogenomics and metabolite measurement for 6-mercaptopurine therapy in inflammatory bowel disease. Gastroenterol. 2000 Apr;118(4):705–13. [PubMed: 10734022]
62.
Gearry RB, Roberts RL, Barclay ML, et al. Lack of association between the ITPA 94C>A polymorphism and adverse effects from azathioprine. Pharmacogenetics. 2004 Nov;14(11):779–81. [PubMed: 15564886]
63.
Hibi T, Naganuma M, Kitahora T, et al. Low-dose azathioprine is effective and safe for maintenance of remission in patients with ulcerative colitis.[see comment] J Gastroenterol. 2003;38(8):740–6. [PubMed: 14505127]
64.
Ishioka S, Hiyama K, Sato H, et al. Thiopurine methyltransferase genotype and the toxicity of azathioprine in Japanese.[see comment] Internal Med. 1999 Dec;38(12):944–7. [PubMed: 10628931]
65.
Kim JH, Cheon JH, Hong SS, et al. Can we predict highly frequent myelotoxicity during azathioprine/6-mercaptopurine treatment in Korean patients with inflammatory bowel disease by thiopurine methyltransferase genotyping and phenotyping or inosine triphosphate pyrophosphatase genotyping? A multicenter study. Gastroenterol. 2008;134
66.
Jojic N, Urosevic J, Bojic B, et al. Determination of thiopurine methyltransferase genotype in the patients with inflammatory bowel disease before and during azathioprine therapy. Arch Gastroenterohepatol. 2003;22(1–2):5–9.
67.
Jun JB, Cho DY, Kang C, et al. Thiopurine S-methyltransferase polymorphisms and the relationship between the mutant alleles and the adverse effects in systemic lupus erythematosus patients taking azathioprine. Clinical & Experimental Rheumatology. 2005 Nov;23(6):873–6. [PubMed: 16396707]
68.
Lopez AJ, Schwab M, Witt H, et al. The impact of genetic variants in TPMT, ITPA, MTHFR, SPINK1 and PRSS1 on azathioprine-induced pancreatitis. Gastroenterol. 2006;130
69.
Marinaki AM, Ansari A, Duley JA, et al. Adverse drug reactions to azathioprine therapy are associated with polymorphism in the gene encoding inosine triphosphate pyrophosphatase (ITPase). Pharmacogenetics. 2004 Mar;14(3):181–7. [PubMed: 15167706]
70.
Palmieri O, Latiano A, Bossa F, et al. Sequential evaluation of thiopurine methyltransferase, inosine triphosphate pyrophosphatase, and HPRT1 genes polymorphisms to explain thiopurines' toxicity and efficacy.[erratum appears in Aliment Pharmacol Ther. 2007 Sep 15;26(6):968] Aliment Pharmacol Ther. 2007 Sep 1;26(5):737–45. [PubMed: 17697207]
71.
Reuther LO, Sonne J, Larsen NE, et al. Pharmacological monitoring of azathioprine therapy. Scand J Gastroenterol Suppl. 2003 Sep;38(9):972–7. [PubMed: 14531535]
72.
Schmeling H, Abdelhaleem M, Benseler S, et al. Role of TPMT genotyping and azathioprine metabolites in predicting toxicity of azathioprine in PSLE patients. Arthritis Rheum. 2007;56(12):4265–6.
73.
Seddik M, Texier F, Ferrari N, et al. Thiopurine S-Methyltransferase Genotyping Does Not Predict Azathioprine-Induced Myelosuppression in Crohn'S Disease. Dig Dis Week Abstr Itinerary Planner. 2003;2003
74.
Stocco G, Martelossi S, Barabino A, et al. Glutathione-S-transferase genotypes and the adverse effects of azathioprine in young patients with inflammatory bowel disease. Inflamm Bowel Dis. 2007 Jan;13(1):57–64. [PubMed: 17206640]
75.
Tamori A, Shinzaki M, Kosaka S, et al. Thiopurine S-methyltransferase gene polymorphism in Japanese patients with autoimmune liver diseases. Liver Internat. 2007 Feb;27(1):95–100. [PubMed: 17241387]
76.
Tani C, Mosca M, Colucci R, et al. Genetic polymorphisms of thiopurine S-methyltransferase in a cohort of patients with systemic autoimmune diseases. Clin Experiment Rheum. 2009;27(2):321–4. [PubMed: 19473575]
77.
van Dieren J, van Vuuren H, Kuipers E, et al. Heterozygous polymorphisms in the genes encoding ITPA and TPMT*3A are not predictive for the development of adverse effects of azathioprine treatment in IBD patients. Gastroenterol. 2005;128
78.
Zelinkova Z, Derijks LJ, Stokkers PC, et al. Inosine triphosphate pyrophosphatase and thiopurine s-methyltransferase genotypes relationship to azathioprine-induced myelosuppression. Clin Gastroenterol Hepatol. 2006 Jan;4(1):44–9. [PubMed: 16431304]
79.
Kolorz M, Bartosova L, Hosek J, et al. Importance of thiopurine S-methyltransferase gene polymorphisms for prediction of azathioprine toxicity. Neuroendocrinol Let. 2009;30(Suppl 1):137–42. [PubMed: 20027160]
80.
Hagaman JT, Kinder BW, Eckman MH. Thiopurine S-methyltranferase testing in idiopathic pulmonary fibrosis: A pharmacogenetic cost-effectiveness analysis. Lung. 2010;188(2):125–32. [PubMed: 20066544]
81.
Gurwitz D, Rodriguez-Antona C, Payne K, et al. Improving pharmacovigilance in Europe: TPMT genotyping and phenotyping in the UK and Spain. Eur J Hum Genet. 2009 Aug;17(8):991–8. [PMC free article: PMC2986553] [PubMed: 19223932]
82.
Compagni A, Bartoli S, Buehrlen B, et al. Avoiding adverse drug reactions by pharmacogenetic testing: a systematic review of the economic evidence in the case of TPMT and AZA-induced side effects. [Review] [32 refs] Int J Technol Assess Health Care. 2008;24(3):294–302. [PubMed: 18601797]
83.
Sayani FA, Prosser C, Bailey RJ, et al. Thiopurine methyltransferase enzyme activity determination before treatment of inflammatory bowel disease with azathioprine: effect on cost and adverse events. Can J Gastroenterol. 2005 Mar;19(3):147–51. [PubMed: 15776134]
84.
Priest VL, Begg EJ, Gardiner SJ, et al. Pharmacoeconomic analyses of azathioprine, methotrexate and prospective pharmacogenetic testing for the management of inflammatory bowel disease. Pharmacoeconomics. 2006;24(8):767–81. [PubMed: 16898847]
85.
Dubinsky MC, Reyes E, Ofman J, et al. A cost-effectiveness analysis of alternative disease management strategies in patients with Crohn's disease treated with azathioprine or 6-mercaptopurine. Am J Gastroenterol. 2005 Oct;100(10):2239–47. [PubMed: 16181376]
86.
Winter J, Walker A, Shapiro D, et al. Cost-effectiveness of thiopurine methyltransferase genotype screening in patients about to commence azathioprine therapy for treatment of inflammatory bowel disease.[see comment] Aliment Pharmacol Ther. 2004 Sep 15;20(6):593–9. [PubMed: 15352906]
87.
Oh KT, Anis AH, Bae SC. Pharmacoeconomic analysis of thiopurine methyltransferase polymorphism screening by polymerase chain reaction for treatment with azathioprine in Korea. Rheumatology. 2004 Feb;43(2):156–63. [PubMed: 12923290]
88.
Marra CA, Esdaile JM, Anis AH. Practical pharmacogenetics: the cost effectiveness of screening for thiopurine s-methyltransferase polymorphisms in patients with rheumatological conditions treated with azathioprine. J Rheum. 2002 Dec;29(12):2507–12. [PubMed: 12465143]
89.
Tavadia SM, Mydlarski PR, Reis MD, et al. Screening for azathioprine toxicity: a pharmacoeconomic analysis based on a target case. J Am Acad Dermatol. 2000 Apr;42(4):628–32. [PubMed: 10727309]
90.
Prashker MJ, Meenan RF. The total costs of drug therapy for rheumatoid arthritis. A model based on costs of drug, monitoring, and toxicity. Arthritis Rheum. 1995 Mar;38(3):318–25. [PubMed: 7880185]
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