PMID- 16618398
OWN - NLM
STAT- MEDLINE
DCOM- 20060515
LR  - 20220316
IS  - 0016-5085 (Print)
IS  - 0016-5085 (Linking)
VI  - 130
IP  - 4
DP  - 2006 Apr
TI  - Association of 6-thioguanine nucleotide levels and inflammatory bowel disease 
      activity: a meta-analysis.
PG  - 1047-53
AB  - BACKGROUND & AIMS: 6-Thioguanine nucleotide (6-TGN) levels have been proposed to 
      correlate with inflammatory bowel disease (IBD) activity among patients treated 
      with azathioprine or 6-mercaptopurine (6-MP). Previous studies, most with small 
      sample sizes, yielded conflicting conclusions. Our aim was to pool the available 
      data to provide a more precise estimate of the association between 6-TGN levels 
      and IBD activity. METHODS: We searched Medline and PubMed (from 1966 to November 
      2004) and reviewed the reference lists of selected articles. Fixed and 
      random-effects models were used to test whether mean/median 6-TGN levels differed 
      among patients with active disease vs remission and whether 6-TGN levels above a 
      threshold of 230-260 pmol/8 x 10(8) red blood cells were associated with clinical 
      remission. When studies reported multiple 6-TGN threshold values, we used the 
      data for the lower value. RESULTS: We identified 55 articles, 12 of which 
      contained data sufficient for inclusion. The mean/median 6-TGN levels were higher 
      among patients in remission than in those with active IBD (pooled difference, 66 
      pmol/8 x 10(8) red blood cells; 95% confidence interval, 18-113; P = .006), but 
      with significant heterogeneity. Excluding the 1 outlier study eliminated this 
      heterogeneity. Patients with 6-TGN levels above the threshold value were more 
      likely to be in remission (62%) than those below the threshold value (36%) 
      (pooled odds ratio, 3.3; 95% confidence interval, 1.7-6.3; P < .001), but with 
      significant heterogeneity. Again, excluding the 1 outlier study eliminated this 
      heterogeneity. CONCLUSIONS: Although prior studies yielded inconsistent 
      conclusions, this analysis strongly supports that higher 6-TGN levels are 
      associated with clinical remission.
FAU - Osterman, Mark T
AU  - Osterman MT
AD  - Division of Gastroenterology, University of Pennsylvania School of Medicine, 
      Philadelphia, Pennsylvania 19104, USA.
FAU - Kundu, Rabi
AU  - Kundu R
FAU - Lichtenstein, Gary R
AU  - Lichtenstein GR
FAU - Lewis, James D
AU  - Lewis JD
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Gastroenterology
JT  - Gastroenterology
JID - 0374630
RN  - 0 (Guanine Nucleotides)
RN  - 0 (Thionucleotides)
RN  - 15867-02-4 (6-thioguanylic acid)
SB  - IM
CIN - Gastroenterology. 2006 Apr;130(4):1352-4. PMID: 16618427
MH  - Guanine Nucleotides/*blood
MH  - Humans
MH  - Inflammatory Bowel Diseases/blood/*physiopathology
MH  - Thionucleotides/*blood
EDAT- 2006/04/19 09:00
MHDA- 2006/05/16 09:00
CRDT- 2006/04/19 09:00
PHST- 2005/09/22 00:00 [received]
PHST- 2005/12/28 00:00 [accepted]
PHST- 2006/04/19 09:00 [pubmed]
PHST- 2006/05/16 09:00 [medline]
PHST- 2006/04/19 09:00 [entrez]
AID - S0016-5085(06)00015-1 [pii]
AID - 10.1053/j.gastro.2006.01.046 [doi]
PST - ppublish
SO  - Gastroenterology. 2006 Apr;130(4):1047-53. doi: 10.1053/j.gastro.2006.01.046.