Personalized Medicine of Thiopurine Therapy in Autoimmune Diseases: Contribution of LC-MS/MS Analysis
Wed 10:30 AM - Track 1: Biomarkers in Drug Discovery
Thierry Dervieux
Exagen Diagnostics
View Long Abstract
Mercaptopurine and azathioprine are thiopurine prodrugs widely used in the treatment of various autoimmune diseases. Both drugs can result in life threatening toxicities due to genetic defect in Thiopurine methyltransferase (TPMT), an enzyme inactivating thiopurine drugs. Molecular diagnostic methods have become standard of care to determine TPMT status. However, the value of a therapeutic drug monitoring with 6-thiopurine metabolites is established, and therapeutic thresholds associated with efficacy and toxicity can help adjust azathioprine and 6-mercapopurine dosage. Liquid chromatography tandem mass spectrometry methods are extremely well positioned to complement molecular diagnostic methods in this growing field of personalized medicine.