Safe 6-thioguanine therapy of a TPMT deficient Crohn's disease patient by using therapeutic drug monitoring

W G N Mares; D R Wong; L P L Gilissen; A A M Masclee; P M Hooymans; L G J B Engels

doi:10.1016/j.crohns.2009.02.002

Safe 6-thioguanine therapy of a TPMT deficient Crohn's disease patient by using therapeutic drug monitoring

J Crohns Colitis. 2009 Jun;3(2):128-30. doi: 10.1016/j.crohns.2009.02.002. Epub 2009 Mar 16.

Authors

W G N Mares¹, D R Wong, L P L Gilissen, A A M Masclee, P M Hooymans, L G J B Engels

Affiliation

¹ Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands.

PMID: 21172256
DOI: 10.1016/j.crohns.2009.02.002

Abstract

The immunosuppressive thiopurines, azathioprine (AZA) and 6-mercaptopurine (6-MP), have proven efficacy in steroid-dependant or refractory inflammatory bowel disease (IBD). In case of TPMT deficiency serious myelosuppression may occur. 6-thioguanine (6-TG), has been suggested in case of AZA and 6-MP resistant or intolerant patients. Our case demonstrates that very low dose 6-TG under close clinical surveillance and frequent therapeutic drug monitoring, may be a rescue drug for IBD-patients with low or without functional TPMT activity.