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Review
. 2010 Jul 7;16(25):3187-95.
doi: 10.3748/wjg.v16.i25.3187.

Thiopurine S-methyltransferase polymorphisms and thiopurine toxicity in treatment of inflammatory bowel disease

Xian-Wen Dong  1 , Qing Zheng, Ming-Ming Zhu, Jing-Lu Tong, Zhi-Hua Ran
Affiliations
Review

Thiopurine S-methyltransferase polymorphisms and thiopurine toxicity in treatment of inflammatory bowel disease

Xian-Wen Dong et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the relationship between thiopurine S-methyltransferase (TPMT) polymorphisms and thiopurine-induced adverse drug reactions (ADRs) in inflammatory bowel disease (IBD).

Methods: Eligible articles that compared the frequency of TPMT polymorphisms among thiopurine-tolerant and -intolerant adult IBD patients were included. Statistical analysis was performed with Review Manager 5.0. Sub-analysis/sensitivity analysis was also performed.

Results: Nine studies that investigated a total of 1309 participants met our inclusion criteria. The incidence of TPMT gene mutation was increased 2.93-fold (95% CI: 1.68-5.09, P = 0.0001) and 5.93-fold (95% CI: 2.96-11.88, P < 0.00001), respectively, in IBD patients with thiopurine-induced overall ADRs and bone marrow toxicity (BMT), compared with controls. The OR for TPMT gene mutation in IBD patients with thiopurine-induced hepatotoxicity and pancreatitis was 1.51 (95% CI: 0.54-4.19, P = 0.43) and 1.02 (95% CI: 0.26-3.99, P = 0.98) vs controls, respectively.

Conclusion: This meta-analysis suggests that the TPMT polymorphisms are associated with thiopurine-induced overall ADRs and BMT, but not with hepatotoxicity and pancreatitis.

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Figures

Figure 1
Figure 1
The flowchart of study selection for the meta-analysis.
Figure 2
Figure 2
Association between thiopurine S-methyltransferase (TPMT) polymorphisms and all adverse drug reactions (ADRs) (A), bone marrow toxicity (B), hepatotoxicity (C) and pancreatitis (D). Total: Total number of patients within the ADRs or no ADRs group; Events: Number of patients with one or more TPMT alleles within the ADRs or no ADRs group. neg assoc: Favoured the no ADRs group; pos assoc: Favoured the ADRs group.
Figure 3
Figure 3
Funnel plot of included studies for this meta-analysis.
See this image and copyright information in PMC

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