Wong et al identified factors associated with hepatotoxicity associated with thiopurine therapy for inflammatory bowel disease (IBD). This can help to identify a patient who may benefit from closer monitoring or an alternative therapy. The authors are from multiple institutions in The Netherlands.
Patient selection: therapy with azathioprine or mercaptopurine in IBD
Outcome: hepatotoxicity. Additional adverse effects include general malaise and gastrointestinal complaints
Parameters from multivariate analysis:
(1) age in years
(2) body mass index (BMI) in kg per square meter
(3) sex
(4) 6-MMPR (6-methylmercaptopurine ribonucleotides) in pmol per 8*10^8 RBC, after 1 week of therapy
Parameter
Finding
Odds Ratio
age in years
<= 50 years
1
> 50 years
4.5
BMI
<= 25 kg per sq m
1
> 25 kg per sq m
3.9
sex
female
1
male
2.5
6-MMPR
<= 3615 pmol/(8*10^8 RBC)
1
> 3615 pmol
3.8
cumulative odds ratio =
= PRODUCT(odds ratios for the 4 parameters)
Interpretation:
• minimum cumulative product: 1
• maximum cumulative product: 166.7
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