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Optimizing Clinical Use of Azathioprine With Newer Pharmacogenetic Data
Stephen E. Wolverton, MD
Arch Dermatol. 2009;145(6):707-710.
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Azathioprine is an antimetabolite immunosuppressive agent that was a major factor in rapidly ushering in the early years of solid organ transplantation. Dermatologists have used this moderate-potency immunosuppressive agent most commonly for bullous dermatoses, such as the pemphigus and pemphigoid spectrums, as well as for leukocytoclastic vasculitis and adults with severe atopic dermatitis. The adverse effects of greatest concern have been hematologic toxic effects (eg, agranulocytosis and pancytopenia) along with lymphoma risk (primarily in patients who have undergone organ transplantation). In addition, liver toxic effects (with or without the presence of the drug hypersensitivity syndrome) and gastrointestinal (GI) tract symptoms, such as nausea and vomiting, can result in the cessation of azathioprine therapy in selected patients (Table).
Table appears in full text version.
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Table. Summary of Tests to Assess Azathioprine Nonresponders
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In 1995, Snow and Gibson1-2 brought the topic of the enzyme thiopurine methyltransferase (TPMT) to the attention of the . . . [Full Text of this Article] IN AN IDEAL WORLD
COMPARABLE SCENARIOS FOR TESTING POLYMORPHISMS OF INTEREST TO DRUG THERAPY
OVERVIEW OF THE STUDY IN THIS ISSUE OF THE ARCHIVES
ADDITIONAL ISSUES RAISED IN THE STUDY
SOME QUESTIONS FOR FUTURE STUDIES
AUTHOR INFORMATION
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