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Why measure thiopurine methyltransferase activity? Direct administration of 6-thioguanine might be the alternative for 6-mercaptopurine or azathioprine
  1. D de JONG,
  2. C J J MULDER,
  3. A A van SORGE
  1. On behalf of the Dutch 6-TG Study Group
  2. Department of Gastroenterology and Pharmacy
  3. Rijnstate Hospital, POB 9555, 6800 TA Arnhem
  4. the Netherlands
  1. Dr C J J Mulder. cjmulder{at}

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Editor,—6-Mercaptopurine (6-MP) and its prodrug azathioprine (AZA) are effective in inflammatory bowel disease (IBD), mainly by their active 6-thioguanine (6-TG) metabolites. Efficacy and also myelotoxicity of 6-MP and AZA seem to be related to the 6-TG levels achieved. Instead of activation to 6-thioguanine nucleotides, 6-MP and AZA can be inactivated to 6-methylmercaptopurine (6-MMP) by the enzyme thiopurine methyltransferase (TPMT). High interindividual variability in TPMT activity is known. Therefore, measuring TPMT activity could be used to …

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