2013
DOI: 10.1038/clpt.2013.4
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Clinical Pharmacogenetics Implementation Consortium Guidelines for Thiopurine Methyltransferase Genotype and Thiopurine Dosing: 2013 Update

Abstract: The Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Thiopurine Methyltransferase Genotype and Thiopurine Dosing was originally published in March 2011. We reviewed recent literature and concluded that although relevant new evidence has been generated, none of the evidence would change the primary dosing recommendations in the original guideline; therefore, the original publication remains clinically current. Up‐to‐date information on thiopurine methyltransferase (TPMT) gene alleles and… Show more

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Cited by 308 publications
(276 citation statements)
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“…Drug metabolized Clinical response due to alteration in pK Thiopurine methyltransferase [12] Mercaptopurine Thioguanine Azathioprine…”
Section: Genementioning
confidence: 99%
See 1 more Smart Citation
“…Drug metabolized Clinical response due to alteration in pK Thiopurine methyltransferase [12] Mercaptopurine Thioguanine Azathioprine…”
Section: Genementioning
confidence: 99%
“…Thiopurine methyltransferase genotype and thiopurine dosing [12] Thiopurines are commonly used not only to treat nonmalignant conditions like inflammatory bowel disease, rheumatoid arthritis, and other immune conditions but are also critical anticancer agents in some hematological malignancies. Azathioprine, mercaptopurine, and thioguanine (TG) are all prodrugs that are inactivated by TPMT.…”
Section: • Cyclophosphamide Toxicitymentioning
confidence: 99%
“…Recommendations include; normal starting dose for homozygous wild type or normal enzyme activity, 30-70% of target dose for heterozygotes or intermediate enzyme activity. Finally, consider alternative therapy or a significant reduction in thiopurine starting dose and reduction in frequency of administration for those with two nonfunctional alleles [20,21]. There is however, a wide variation in clinical practice guidelines across different specialty units [22].…”
Section: Introductionmentioning
confidence: 99%
“…Although for homozygotes, the dosage should be reduced by 90%. 9 As technology improves, PGx, on the basis of single candidate genes such as the TPMT gene, is evolving into pharmacogenomics, in which genome-wide patterns of single-nucleotide polymorphisms could be identified to help guide therapy. 10 Thus, unlike PGx, pharmacogenomics accounts for interaction effects between multiple genes.…”
mentioning
confidence: 99%
“…5 As an example of PGx testing, when treating acute lymphoblastic leukemia, current standard of practice requires that azathioprine be dosed according to the genotype of the thiopurine methyltransferase (TPMT) enzyme. 9 Specifically, for heterozygotes of mutant TPMT alleles (ie, alleles *2, *3A, *3B, and *4), the dosage of azathioprine should be reduced by 50% to 75%. Although for homozygotes, the dosage should be reduced by 90%.…”
mentioning
confidence: 99%