Citations 2
Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Thiopurine Dosing Based on TPMT and NUDT15 Genotypes: 2025 Update
Maillard, M., Schwab, Matthias, Whirl-Carrillo, Michelle, Moyer, AM , Suarez‐Kurtz, Guilherme , Pui, CH, Stein, C Michael, Klein, Teri E. , Spahn, Claire , Kwon, Sooyeon, Boer, Nanne K de, Ahmad, Tariq, Antillon-Klussmann, Federico Guillermo, Caudle, Kelly E. , Yeoh, Allen E J, Schmiegelow, K., Yang, Jun J, Schwab, Matthias , Maillard, Maud , Maillard, Maud , Schwab, Matthias , Whirl-Carrillo, Michelle , Caudle, Kelly E , Kato, Motohiro , Klein, Teri E , Whirl‐Carrillo, Michelle , Stein, C. Michael, Hartono, Juanda Leo , Ahmad, Tariq , Antillon‐Klussmann, Federico Guillermo, Kato, Motohiro , Yeoh, Allen Eng Juh
Clinical Pharmacology & Therapeutics | January 31, 2026 | Volume: 119 | Issue: 4 | Pages: 916-927
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 on www.clinpgx.org ).
Clinical Pharmacogenetics Implementation Consortium Guideline for Thiopurine Dosing Based on TPMT and N
Relling, Mary V. , Schwab, Matthias , Whirl‐Carrillo, Michelle , Suarez‐Kurtz, Guilherme , Pui, Ching‐Hon, Stein, Charles, Moyer, Ann M. , Evans, William E. , Klein, Teri E. , Antillon‐Klussmann, Federico Guillermo, Caudle, Kelly E. , Yeoh, Allen Eng Juh , Antillón‐Klussmann, Federico , Yang, Jun J.J. , Whirl-Carrillo, Michelle , Klein, Teri E , Yeoh, Allen E J , Pui, Ching-Hon , Kato, Motohiro , Schmiegelow, Kjeld , Schwab, Matthias
Clinical Pharmacology & Therapeutics | November 17, 2018 | Volume: 105 | Issue: 5 | Pages: 1095-1105
Thiopurine methyltransferase (TPMT) activity exhibits a monogenic codominant inheritance and catabolizes thiopurines. TPMT variant alleles are associated with low enzyme activity and pronounced pharmacologic effects of thiopurines. Loss‐of‐function alleles in the NUDT15 gene are common in Asians and Hispanics and reduce the degradation of active thiopurine nucleotide metabolites, also predisposing to myelosuppression. We provide recommendations for adjusting starting doses of azathioprine, mercaptopurine, and thioguanine based on TPMT and NUDT15 genotypes (updates on www.cpicpgx.org ).