NUDT15 Polymorphism Explains Serious Toxicity to Azathioprine in Indian Patients With Chronic Immune Thrombocytopenia and Autoimmune Hemolytic Anemia: A Case Series

    August 2020 in “ Drug metabolism and drug interactions ”
    Anup J. Devasia, Raveen Stephen Stallon Illangeswaran, Infencia Xavier Raj, Biju George, Poonkuzhali Balasubramanian
    Image
    Studysummary This case series found that patients with the NUDT15 415C>T variant experienced severe azathioprine toxicity, suggesting genotype-based dosing could reduce adverse effects. Our plain-language summary of this paper — not a Tressless recommendation.
    The document reported a case series of five Indian patients who experienced severe toxicity (myelosuppression, hair loss, and oral ulcers) while being treated with azathioprine (AZA) for autoimmune hemolytic anemia (n=1) and immune thrombocytopenia (n=4). These patients did not have common TPMT variants but all had the NUDT15 415C>T variant, which has been linked to serious toxicity in Asian patients. The findings suggested that pre-emptive genotype-based dosing of AZA could mitigate adverse effects and improve patient outcomes.
    Discuss this study in the Community →