Clinical Pharmacokinetic and Pharmacodynamic Considerations in the Treatment of Ulcerative Colitis

Clinical Pharmacokinetics
Sophie E BerendsRon A A Mathôt

Abstract

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) of unknown etiology, probably caused by a combination of genetic and environmental factors. The treatment of patients with active UC depends on the severity, localization and history of IBD medication. According to the classic step-up approach, treatment with 5-aminosalicylic acid compounds is the first step in the treatment of mild to moderately active UC. Corticosteroids, such as prednisolone are used in UC patients with moderate to severe disease activity, but only for remission induction therapy because of side effects associated with long-term use. Thiopurines are the next step in the treatment of active UC but monotherapy during induction therapy in UC patients is not preferred because of their slow onset. Therapeutic drug monitoring (TDM) of the pharmacologically active metabolites of thiopurines, 6-thioguanine nucleotide (6-TGN), has proven to be beneficial. Thiopurine S-methyltransferase (TMPT) plays a role in the metabolic conversion pathway of thiopurines and exhibits genetic polymorphism; however, the clinical benefit and relevance of TPMT genotyping is not well established. In patients with severely active UC refractory to corticosteroids, calcineurin i...Continue Reading

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Citations

Jul 28, 2020·Digestive Diseases and Sciences·Courtney PerryTerrence A Barrett
Nov 23, 2018·Expert Opinion on Drug Metabolism & Toxicology·Marianna LucafòGabriele Stocco
Oct 1, 2019·Gastroenterology Research and Practice·Marco DapernoPaolo Gionchetti
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Jan 7, 2021·Biomaterials Science·Priyanka VermaAvinash Bajaj
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Feb 23, 2021·Asian Journal of Pharmaceutical Sciences·Iria Seoane-ViañoAlvaro Goyanes
Mar 26, 2021·Evidence-based Complementary and Alternative Medicine : ECAM·Xiuhong KangShengsheng Zhang
Mar 29, 2021·Cytokine & Growth Factor Reviews·Yijie SongNing Zhang
Apr 7, 2019·Trends in Molecular Medicine·Sruthi Vijaya Retnakumar, Sylviane Muller
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Methods Mentioned

BETA
genotyping
biopsies

Software Mentioned

TAILORIX
GEMINI

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