Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Thiopurine Dosing Based on TPMT and NUDT15 Genotypes: 2025 Update
St. Jude Children's Research Hospital · Centre de Recherche en Cancérologie de Toulouse · +24 more institutions
Abstract
Thiopurine methyltransferase (TPMT) and Nudix hydrolase 15 (NUDT15) are key enzymes that catabolize thiopurines. Decreased or no-function alleles in TPMT and NUDT15 are associated with reduced or no enzyme activity and predictive of pronounced adverse effects, including severe myelosuppression, that may occur among individuals treated with standard doses of thiopurines. Genetic variants in these genes are present in all world populations; however, their frequency varies by ancestry. In this updated guideline, we provide recommendations for adjusting starting doses of mercaptopurine, thioguanine, and azathioprine based on TPMT and NUDT15 genotypes, including for individuals with variants in both genes (updates…
Citation impact
- FWCI
- 103.67
- Percentile
- 100%
- References
- 0
Authors
19- MMM. Maillard
St. Jude Children's Research Hospital, Centre de Recherche en Cancérologie de Toulouse, Institut Claudius Regaud
- MSMatthias Schwab
Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, University of Tübingen
- MWMichelle Whirl-Carrillo
Stanford University
- AMAM Moyer
Mayo Clinic, Mayo Clinic in Arizona, Mayo Clinic in Florida
- GSGuilherme Suarez‐Kurtz
Instituto Nacional de Câncer - INCA
Topics & keywords
- Thiopurine methyltransferase
- Pharmacogenetics
- Dosing
- Azathioprine
- Guideline
- Pharmacogenomics
- Adverse effect