Review article

https://doi.org/https://doi.org/10.2478/acph-2024-0030

Personalization of thiopurine therapy: Current recommendations and future perspectives

DUNJA URBANČIČ ; University of Ljubljana, Faculty of Pharmacy, 1000 Ljubljana, Slovenia
FLAKA PASHA ; University of Ljubljana, Faculty of Pharmacy, 1000 Ljubljana, Slovenia; University of Prishtina “Hasan Prishtina”, Faculty of Medicine, Department of Pharmacology with Toxicology, and Clinical Pharmacology, 10000 Prishtina, Kosovo
ALENKA ŠMID ; University of Ljubljana, Faculty of Pharmacy, 1000 Ljubljana, Slovenia
IRENA MLINARIČ-RAŠČAN ; University of Ljubljana, Faculty of Pharmacy, 1000 Ljubljana, Slovenia *

* Corresponding author.

Abstract

1 University of Ljubljana, Faculty of Pharmacy, 1000 Ljubljana, Slovenia
2 University of Prishtina “Hasan Prishtina”, Faculty of Medicine, Department of Pharmacology with Toxicology, and Clinical Pharmacology, 10000 Prishtina, Kosovo

Despite great therapeutic advances in the field of biologics, small synthetic molecules such as thiopurines, including azathioprine, mercaptopurine, and thioguanine, remain an important therapeutic pillar in the treatment of inflammatory bowel disease, other autoimmune disorders, and cancer. This review presents the latest guidelines for thiopurine administration, highlighting the importance of individualized therapy guided by pharmacogenomics. It emphasizes dose adjustment based on nudix hydrolase 15 (NUDT15) and thiopurine S-methyltransferase (TPMT) genotype, alongside thiopurine S-methyltransferase activity and thiopurine metabolic profile. In addition, the article takes a critical look at emerging research in the field of thiopurine pharmacogenomics featuring novel genetic markers and technological developments in genetic testing. Finally, the potential of integrated approaches that combine genetic, metabolic, and clinical factors to further individualize thiopurine therapy is highlighted.

Keywords

thiopurines; TPMT; NUDT15; personalized medicine; therapeutic drug monitoring

Hrčak ID:

320529

URI

https://hrcak.srce.hr/320529

Publication date:

30.9.2024.

Visits: 0 *