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Crohn's Disease Forum » Books, Multimedia, Research & News » Thiopurine drugs may increase risk of pancreatitis: Genetic Markers


10-13-2014, 03:17 AM   #1
DustyKat
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Thiopurine drugs may increase risk of pancreatitis: Genetic Markers

Doctors have discovered that patients with a particular genetic variation are four times more likely to develop pancreatitis if they are prescribed a widely used group of drugs.

Clinicians at the Royal Devon and Exeter NHS Foundation Trust and the University of Exeter Medical School have discovered that 17 per cent of patients who have two copies of a particular genetic marker are likely to go on to develop pancreatitis if they are prescribed thiopurine drugs. The drugs, which include azathioprine and mercaptopurine, are some of the most effective and most commonly used drugs to suppress the immune system in the treatment of Inflammatory Bowel Disease (IBD), rheumatoid arthritis and after some organ transplants.

It has long been recognised that about four per cent of patients who are prescribed these drugs for IBD go on to develop pancreatitis, an inflammation of the pancreas, which can be fatal. But in a study published in Nature Genetics, doctors have identified a group of patients whose genetic make-up means they are more than four times more likely to develop the condition when given these drugs.

Dr Graham Heap was part of a team led by Dr Tariq Ahmad, a gastroenterologist at the Royal Devon & Exeter NHS Foundation Trust, working with the University of Exeter Medical School to coordinate input from over 150 hospitals around the world. Doctors around the UK and Europe, and as far afield as Canada and Australia sent genetic data on IBD patients who developed pancreatitis to allow the team to identify regions of the genome which could make people more susceptible to developing this serious drug side effect.

Dr Heap said: "Our collaboration, which involves clinicians around the world, is seeking to identify tests to enable doctors to predict which patients will develop serious drug side effects. We can now theoretically identify which patients could be at increased risk of developing pancreatitis. We are hoping that this test will be formed into a tool kit of DNA based tests that also assess other important side effects of these drugs such as liver damage or white blood cell counts. We would then be able to use this to identify at-risk patients and ultimately save lives."

The team found a genetic marker in the HLA area of the genome, which is associated with how the body responds to infection. People with two copies of the marker had a 17 per cent chance of developing pancreatitis after being given a thiopurine, while those with one copy had a nine per cent chance.

Dr Mike Weedon, of the University of Exeter Medical School, said the research was an excellent example of clinicians and scientists working together for the benefit of advancing better treatment. He said: "The future of healthcare innovation centres around science answering clinical need, and this international collaboration is a prime example of the partnership between researchers and clinicians proving invaluable.

http://www.medicalnewstoday.com/releases/282627.php
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10-14-2014, 11:07 AM   #2
sashaz
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I have been on a azathioprine then went to Humira and then back to azo. During the humira phaze I went to hospital and was diagnosed with Pancreatis. Now I have to have creon with every meal.
10-16-2014, 08:21 PM   #3
Pilgrim
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My daughter had pancreatitis from Aza at age 3. Boy was that a nightmare. I wish there had been a genetic screen for that. I wonder how they can tell if she will have a life long effect from the pancreatits. Now she is not taking anything for her Crohn's. EEN for now. Creon? I'll have to look that up.
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Current Treatment: Humira (started 12/2014) moved to weekly injections (07/2015), Back to 50% EN orally. Zinc supplements. Calprotectin through the roof.
Previous Treatment: Azathioprine (discontiued 09/14 due to Pancreatitis) Flagyl, Sulfasalazine, EEN, Iron,Vit D, Zinc, SCD
10-18-2014, 03:56 AM   #4
sashaz
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Creon is a digestive enzyme tablet.


10-18-2014, 07:54 AM   #5
Pilgrim
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I looked it up and I was dismayed that a person can have permanent damage like that to the pancreas. Humira did that to you? Not the Aza? Are you sure? Because we've been offered Humira now and I don't want to do any more damage to her pancreas. Darn.
10-21-2014, 01:42 AM   #6
rollinstone
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Dusty, do you have any idea what the actual test is called?
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