%0 Journal Article %J J Crohns Colitis %D 2010 %T Usefulness of the measurement of azathioprine metabolites in the assessment of non-adherence. %A Stocco, Gabriele %A Londero, Margherita %A Campanozzi, Angelo %A Martelossi, Stefano %A Marino, Sara %A Malusà, Noelia %A Bartoli, Fiora %A Decorti, Giuliana %A Ventura, Alessandro %K 6-Mercaptopurine %K Adolescent %K Azathioprine %K Child %K Child, Preschool %K Female %K Guanine Nucleotides %K Hepatitis, Autoimmune %K Humans %K Immunosuppressive Agents %K Inflammatory Bowel Diseases %K Male %K Medication Adherence %K Thionucleotides %K Young Adult %X

Azathioprine is a thiopurine immunosuppressive antimetabolite used to chronically treat inflammatory bowel disease and autoimmune hepatitis. Azathioprine treatment is a long-term therapy and therefore it is at risk for non-adherence, which is considered an important determinant of treatment inefficacy. Measurement of 6-thioguanine and 6-methylmercaptopurine nucleotides has been recently suggested as a screener for non-adherence detection. We describe four young patients in which non-adherence to azathioprine therapy was detected only through the measurement of drug metabolite concentrations, and the criterion for non-adherence was undetectable metabolite levels. After the identification of non-adherence, patients and their families were approached and the importance of a correct drug administration was thoroughly enlightened and discussed; this allowed obtaining a full remission in all subjects. Our observations support the use of undetectable metabolite levels as indicators of non-adherence to therapy in azathioprine treated patients. The additional level of medical supervision given by this assay allows getting a better adherence to medical treatment, which results in an improvement in the response to therapy; these benefits may justify the costs associated with the assay.

%B J Crohns Colitis %V 4 %P 599-602 %8 2010 Nov %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/21122567?dopt=Abstract %R 10.1016/j.crohns.2010.04.003