Assessment of NUDT15 before Thiopurine Treatment in Inflammatory Bowel Disease: An Asian Perspective

Authors

  • Md. Yasir Arafat Medical Officer, National Gastroliver Institute and Hospital, Dhaka, Bangladesh Author
  • Md. Saifuddoula Professor and Director, National Gastroliver Institute and Hospital, Dhaka Author
  • Touhidul Karim Majumder Professor, National Gastroliver Institute and Hospital, Dhaka Author
  • Md. Iqbal Hossain Consultant, National Gastroliver Institute and Hospital, Dhaka Author
  • Rashedul Hasan Assistant Professor, National Gastroliver Institute and Hospital, Dhaka Author

Keywords:

Inflammatory bowel disease, Thiopurine metabolism, NUDT15 genotypes

Abstract

Background: Thiopurines, consisting of mercaptopurine and azathioprine, are used as immunosuppressants in treating inflammatory bowel disease. They are used to maintain remission of IBD patients. These drugs sometimes cause severe adverse effects, particularly myelosuppression, hepatoxicity, and pancreatitis. Recent advancements in pharmacogenomics have identified different genetic variants, including TMPT and Nudix hydrolase-15 (NUDT15). NUDT15 polymorphisms have been shown to play an important role in thiopurine-induced adverse reactions in Asians. This review article provides an insight into the NUDT15 testing before initiating thiopurine therapy in Asian patients with IBD.

Conclusion: In this article, the metabolism and pharmacogenetics of thiopurines, the prevalence and impact of NUDT15 variants in Asia, clinical guidelines for the importance of NUDT15 testing, dose adjustment based on NUDT15 genotypes, and monitoring and follow-up of the patients being treated are discussed.

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Published

2025-05-20

Issue

Vol. 1 No. 1 (2025): Volume 1 · Issue 1 · June 2025

Section

Review Articles