Kiszka-Kanowitz Marianne, Theede Klaus, Nielsen Anette Mertz
Gastroenheden, Medicinsk -sektion, Hvidovre Hospital, Kettegårds Allé 30, 2650 Hvidovre.
Ugeskr Laeger. 2014 May 26;176(22).
Thiopurines are effective in maintaining remission in chronic inflammatory bowel diseases, but incomplete response or side effects are common during standard-dose treatment. In this article thiopurine metabolism and pharmacogenetic aspects are summarized showing their benefits in improving therapy in chronic inflammatory bowel disease. An increasing body of evidence suggests that a large part of the observed non-pancreatic side effects and poor responses can be solved by tailoring thiopurine therapy using measurement of thiopurine methyltransferase and metabolites and by using a combination therapy with low-dose thiopurines and allopurinol.
硫嘌呤类药物对维持慢性炎症性肠病的缓解有效，但在标准剂量治疗期间，不完全缓解或副作用很常见。本文总结了硫嘌呤代谢和药物遗传学方面的内容，显示了它们在改善慢性炎症性肠病治疗方面的益处。越来越多的证据表明，通过测量硫嘌呤甲基转移酶和代谢产物来调整硫嘌呤治疗方案，以及采用低剂量硫嘌呤与别嘌呤醇联合治疗，可以解决大部分观察到的非胰腺副作用和疗效不佳的问题。
