Azathioprine dosed by thiopurine methyltransferase activity for moderate-to-severe atopic eczema: a double-blind, randomised controlled trial

Lancet
S J MeggittN J Reynolds

Abstract

Atopic eczema affects 1-2% of adults, and can cause considerable morbidity. We aimed to assess the safety and efficacy of azathioprine as systemic monotherapy for moderate-to-severe atopic eczema, and the therapeutic importance of the thiopurine methyltransferase (TPMT) polymorphism (a key determinant of azathioprine-induced myelotoxicity) by using TPMT enzyme activity to establish azathioprine dose. We did a parallel-group, double-blind, placebo-controlled trial in an outpatient setting. Minimisation was used to assign 63 patients with active disease despite optimum topical therapy to treatment with azathioprine (n=42) or placebo (n=21) for 12 weeks. As maintenance treatment, patients with heterozygous range TPMT activity received azathioprine 1.0 mg/kg daily, compared with 2.5 mg/kg daily in patients with normal TPMT activity. For the first 4 weeks, all participants received lower azathioprine doses (0.5 and 1.0 mg/kg daily, respectively) to reduce gastrointestinal side-effects. The primary measure of clinical response was disease activity assessed by the SASSAD (six area six sign atopic dermatitis) score. Analysis was by intention-to-treat. This study is registered as an International Standard Randomised Controlled Trial, nu...Continue Reading

References

Sep 1, 1978·Archives of Dermatology·C R White, J M Hanifin
Aug 1, 1991·Journal of the American Academy of Dermatology·I R YoungerG B Colver
Jan 27, 1990·BMJ : British Medical Journal·J N MatthewsP Royston
Mar 10, 1990·BMJ : British Medical Journal·S Senn
Jan 1, 1985·Statistics in Medicine·J Cuzick
Nov 13, 1993·Lancet·P J KerstensA M Boerbooms
May 1, 1994·Clinical and Experimental Dermatology·A Y Finlay, G K Khan
Aug 24, 1996·Lancet·A P ParnhamC Dudley
Jul 1, 1996·The British Journal of Dermatology·R M HerdJ A Hunter
Jan 1, 1997·Archives of Dermatological Research·H N Liu, C K Wong
May 15, 1998·The British Journal of Dermatology·A V PowlesL Fry
Oct 23, 1998·Journal of the European Academy of Dermatology and Venereology : JEADV·D A BuckleyS Rogers
Dec 2, 1999·Journal of the National Cancer Institute·M V RellingW E Evans
Dec 21, 2000·Clinical and Experimental Dermatology·K Thestrup-Pedersen
Apr 12, 2001·The British Journal of Dermatology·T LugerJ D Bos
Aug 8, 2001·Clinical and Experimental Dermatology·S J Meggitt, N J Reynolds
Jul 13, 2002·American Journal of Clinical Dermatology·Sakari ReitamoJohanna Saarikko
Jul 30, 2002·Alimentary Pharmacology & Therapeutics·A G FraserD P Jewell
Aug 14, 2002·The British Journal of Dermatology·J Berth-JonesR A C Graham-Brown
Jun 6, 2003·The Journal of Investigative Dermatology·Carolyn CharmanHywel Williams
Oct 10, 2003·Cancer Investigation·Howard L McLeod, Jinsheng Yu

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Citations

May 16, 2008·Journal of Neurology·P GoldsmithN Bhalla
Dec 30, 2009·Actas dermo-sifiliográficas·I BallesterA Lucas
Aug 2, 2007·Journal of Clinical Gastroenterology·Ashwin N AnanthakrishnanDavid G Binion
Oct 5, 2011·Pediatric Dermatology·Weston T WaxweilerDean S Morrell
Apr 5, 2012·Pediatric Dermatology·Vasanop VachiramonGil Yosipovitch
Mar 11, 2006·BMJ : British Medical Journal·Sara Brown, Nick J Reynolds
Jul 21, 2007·BMJ : British Medical Journal·Sophie WeatherheadNick J Reynolds
Jan 1, 2010·Clinical, Cosmetic and Investigational Dermatology·Hobart W Walling, Brian L Swick
Mar 12, 2009·Drugs·Giampaolo RicciMassimo Masi
May 17, 2012·Clinical Medicine : Journal of the Royal College of Physicians of London·Hannah Cookson, Catherine Smith
Dec 19, 2009·Pharmacogenomics·Ana AlfirevicMunir Pirmohamed
May 14, 2014·Drugs·Christian Vestergaard, Mette Deleuran
Nov 22, 2014·Dermatologic Clinics·Amy C Foulkes, Richard B Warren
Nov 23, 2007·Dermatology : International Journal for Clinical and Investigative Dermatology·Laurence Le CleachOlivier Chosidow
Sep 7, 2006·Current Opinion in Allergy and Clinical Immunology·William Abramovits, Amy Perlmutter
Dec 3, 2014·Journal of the American Academy of Dermatology·Nicholas R FuggleVeronica A Kinsler
Jan 29, 2016·American Journal of Clinical Dermatology·Christine BlomeMatthias Augustin
Feb 5, 2013·The Journal of Allergy and Clinical Immunology·Lynda SchneiderDana Wallace
Dec 30, 2015·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Thomas WerfelUNKNOWN Association of Scientific Medical Societies of Germany
Mar 17, 2012·Clinical Therapeutics·Manuel RománFrancisco Abad-Santos
Jan 1, 2016·Annals of Dermatology·Hemin LeeKwang Hoon Lee
Apr 26, 2011·The Journal of Allergy and Clinical Immunology·Mandy Elvira SchramPhyllis Ira Spuls
Apr 23, 2010·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Sung-Il WooYoun-Soo Hahn
Jan 23, 2015·The Journal of Investigative Dermatology·Antoinette I M van LaarhovenAndrea W M Evers
Nov 11, 2008·The Journal of Allergy and Clinical Immunology·Thomas Jung, Georg Stingl
May 10, 2008·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Sharon J GardinerMurray L Barclay
Sep 11, 2007·The Nursing Clinics of North America·Susan Tofte
Apr 18, 2007·Journal of the American Academy of Dermatology·Kenneth Y Tsai, Hensin Tsao
Nov 9, 2015·Paediatric Drugs·Eliza R Notaro, Robert Sidbury
Jan 17, 2007·The British Journal of Dermatology·S C WeatherheadS J Meggitt
Nov 1, 2007·Dermatologic Therapy·Melissa Wise, Jeffrey P Callen
Apr 9, 2008·Dermatologic Therapy·Bruce H Thiers
Jul 21, 2012·Journal of the European Academy of Dermatology and Venereology : JEADV·J RingUNKNOWN Global Allergy and Asthma European Network
Jul 17, 2013·The British Journal of Dermatology·L E ProudfootUNKNOWN European Dermato-Epidemiology Network (EDEN)
Mar 29, 2012·The British Journal of Dermatology·A N PatelJ M Batchelor
Apr 5, 2013·Dermatologic Therapy·Kevin B YarbroughEric L Simpson
Jan 28, 2012·Journal of the European Academy of Dermatology and Venereology : JEADV·I M HaeckM J Knol
Mar 24, 2016·Journal of the European Academy of Dermatology and Venereology : JEADV·A WollenbergUNKNOWN European Task Force on Atopic Dermatitis/EADV Eczema Task Force

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