Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Hi I have tried 6mp on 2 seperate occasions. Predisone was the only med controlling my UC so my GI wanted me to try 6mp. The first time I tried it, my bile ducts became blocked and needed to be drained and this last time I tried it I ended up getting pancreatitis so no more 6mp for me. I know they have had great success with it but I'm just very sensitive to certain meds and it didn't work for me. Its worth giving it a try, he'll just need to be monitored to make sure it doesn't cause any issues with his liver. Good luck and if you have any other questions please feel free to e mail me.SerbrinaUC '01/PSC '04Sent via BlackBerry by AT&TFrom: Hussey Date: Wed, 25 Mar 2009 09:26:12 -0400To: < >Subject: 6MP for UC? Anyone tried 6MP for UC? Fred's gastro doesn't want to keep him on steroids after this latest UC flare up clears up and is considering 6MP, but she said she'll need to study it to determine if it's safe for PSC patients. We're in the process of switching Fred to a new liver doc, so can't get any help in that regard until he's seen. By the way, I've decided that good things do NOT come in 3's, as noted by my sign off! Wife of Fred, PSC 03/04, UC 03/06, Pancreatitis, BUBBA, UC Flare 03/09 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Actually when Todd was first diagnosed with PSC in 2001 his pediatric hepatologist put him on 6MP for PSC…at the time he had not been diagnosed with IBD. He was eventually taken off the drug because of side effects. Joanne (mom of Todd, 23, PSC 01, Crohns 02, TX Twice 03, rPSC 05, Diabetes 06, AIH overlap 08 & living life to the fullest 09) Anyone tried 6MP for UC? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Dear ; I've collected over 450 references on 6-MP: http://www.psc-literature.org/6-MP.htm There are a lot of potential side-effects. Some of the side-effects seem to be related to the activity of an enzyme called thiopurine methyltransferase, and so some researchers recommend testing for this enzyme before starting this therapy. See for example: _____________________ Clin Gastroenterol Hepatol. 2004 Sep;2(9):731-43. Azathioprine, 6-mercaptopurine in inflammatory bowel disease: pharmacology, efficacy, and safety. Dubinsky MC Pediatric IBD Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. 6-Mercaptopurine and its prodrug azathioprine remain the mainstay of immunomodulator therapy for the maintenance of a steroid-free remission in patients with IBD. Recent evidence suggests that the cytotoxic and immunosuppressive effects of azathioprine might be mediated via the induction of lymphocyte apoptosis by its active metabolites, 6-thioguanine nucleotides. The therapeutic benefits of thiopurines have been shown to correlate with the concentration of 6-thioguanine nucleotides. Inherited differences in drug metabolism and disposition can significantly impact the safety and efficacy of these drugs. The thiopurine methyltransferase enzyme plays an important role in the metabolism of 6-mercaptopurine and azathioprine and in the determination of thiopurine cytotoxicity. By gaining an understanding of the pharmacology and metabolism of thiopurine therapy and putting it into the clinical context, clinicians will be able to optimize thiopurine therapy in IBD. PMID: 15354273. _____________________ Ann Clin Biochem. 2004 Jul;41(Pt 4):294-302. Thiopurine methyltransferase: should it be measured before commencing thiopurine drug therapy? on J, Ansari A, Marinaki T, Duley J Departments of Purine Research and Gastroenterology, Guy's & St ' Hospitals, London SE1 7EH, UK jeremy.sanderson@... Thiopurines [azathioprine (AZA), 6-mercaptopurine (6-MP) and thioguanine (6-TG)] have a well-established role as immunosuppressive agents in a variety of chronic inflammatory conditions, haematological neoplasia and in transplant rejection. Despite good overall clinical response rates, particularly when used as steroid sparing agents, adverse effects are a limiting problem leading to withdrawal in up to a quarter of patients. Severe myelosuppression is the most serious toxicity occurring early or occasionally later during treatment. An understanding of the competing pathways involved in the metabolism of thiopurines has important implications for predicting some of the more severe toxicity seen with these drugs. Thiopurine methyl transferase (TPMT) is an enzyme catalysing the methylation of 6-MP, competing with xanthine oxidase (XO) and hypoxanthine guanine phosphoribosyl transferase (HGPRT) to determine the amount of 6-MP metabolised to cytotoxic thioguanine nucleotides. Allelic polymorphisms in the TPMT gene predict the activity of the enzyme such that 1 in 10 of the population are heterozygous and have approximately 50% of normal activity, whilst 1 in 300 are completely deficient. As a result, these individuals are at high risk of severe myelosuppression. Conversely, individuals with very high levels of TPMT activity are hyper-methylators in whom clinical response is less likely. Prior knowledge of TPMT status avoids exposure of individuals with zero TPMT to potentially fatal treatment with AZA or 6-MP and provides one of the best examples of predictive pharmacogenetics in therapeutics. This article reviews literature on the role of TPMT measurement prior to treatment with thiopurines and provides some guidance to the use of TPMT as a guide to tailoring thiopurine therapy. PMID: 15298741. _________________________ Best regards, Dave (father of (23); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Dear ; I've collected over 450 references on 6-MP: http://www.psc-literature.org/6-MP.htm There are a lot of potential side-effects. Some of the side-effects seem to be related to the activity of an enzyme called thiopurine methyltransferase, and so some researchers recommend testing for this enzyme before starting this therapy. See for example: _____________________ Clin Gastroenterol Hepatol. 2004 Sep;2(9):731-43. Azathioprine, 6-mercaptopurine in inflammatory bowel disease: pharmacology, efficacy, and safety. Dubinsky MC Pediatric IBD Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. 6-Mercaptopurine and its prodrug azathioprine remain the mainstay of immunomodulator therapy for the maintenance of a steroid-free remission in patients with IBD. Recent evidence suggests that the cytotoxic and immunosuppressive effects of azathioprine might be mediated via the induction of lymphocyte apoptosis by its active metabolites, 6-thioguanine nucleotides. The therapeutic benefits of thiopurines have been shown to correlate with the concentration of 6-thioguanine nucleotides. Inherited differences in drug metabolism and disposition can significantly impact the safety and efficacy of these drugs. The thiopurine methyltransferase enzyme plays an important role in the metabolism of 6-mercaptopurine and azathioprine and in the determination of thiopurine cytotoxicity. By gaining an understanding of the pharmacology and metabolism of thiopurine therapy and putting it into the clinical context, clinicians will be able to optimize thiopurine therapy in IBD. PMID: 15354273. _____________________ Ann Clin Biochem. 2004 Jul;41(Pt 4):294-302. Thiopurine methyltransferase: should it be measured before commencing thiopurine drug therapy? on J, Ansari A, Marinaki T, Duley J Departments of Purine Research and Gastroenterology, Guy's & St ' Hospitals, London SE1 7EH, UK jeremy.sanderson@... Thiopurines [azathioprine (AZA), 6-mercaptopurine (6-MP) and thioguanine (6-TG)] have a well-established role as immunosuppressive agents in a variety of chronic inflammatory conditions, haematological neoplasia and in transplant rejection. Despite good overall clinical response rates, particularly when used as steroid sparing agents, adverse effects are a limiting problem leading to withdrawal in up to a quarter of patients. Severe myelosuppression is the most serious toxicity occurring early or occasionally later during treatment. An understanding of the competing pathways involved in the metabolism of thiopurines has important implications for predicting some of the more severe toxicity seen with these drugs. Thiopurine methyl transferase (TPMT) is an enzyme catalysing the methylation of 6-MP, competing with xanthine oxidase (XO) and hypoxanthine guanine phosphoribosyl transferase (HGPRT) to determine the amount of 6-MP metabolised to cytotoxic thioguanine nucleotides. Allelic polymorphisms in the TPMT gene predict the activity of the enzyme such that 1 in 10 of the population are heterozygous and have approximately 50% of normal activity, whilst 1 in 300 are completely deficient. As a result, these individuals are at high risk of severe myelosuppression. Conversely, individuals with very high levels of TPMT activity are hyper-methylators in whom clinical response is less likely. Prior knowledge of TPMT status avoids exposure of individuals with zero TPMT to potentially fatal treatment with AZA or 6-MP and provides one of the best examples of predictive pharmacogenetics in therapeutics. This article reviews literature on the role of TPMT measurement prior to treatment with thiopurines and provides some guidance to the use of TPMT as a guide to tailoring thiopurine therapy. PMID: 15298741. _________________________ Best regards, Dave (father of (23); PSC 07/03; UC 08/03) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Suzanne was on 6MP for a long time for her UC, they kept a close eye on her liver, but we were doing that for the PSC anyway.Good luckLINDASent via BlackBerry from T-MobileFrom: Hussey Date: Wed, 25 Mar 2009 09:26:12 -0400To: < >Subject: 6MP for UC? Anyone tried 6MP for UC? Fred's gastro doesn't want to keep him on steroids after this latest UC flare up clears up and is considering 6MP, but she said she'll need to study it to determine if it's safe for PSC patients. We're in the process of switching Fred to a new liver doc, so can't get any help in that regard until he's seen. By the way, I've decided that good things do NOT come in 3's, as noted by my sign off! Wife of Fred, PSC 03/04, UC 03/06, Pancreatitis, BUBBA, UC Flare 03/09 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Suzanne was on 6MP for a long time for her UC, they kept a close eye on her liver, but we were doing that for the PSC anyway.Good luckLINDASent via BlackBerry from T-MobileFrom: Hussey Date: Wed, 25 Mar 2009 09:26:12 -0400To: < >Subject: 6MP for UC? Anyone tried 6MP for UC? Fred's gastro doesn't want to keep him on steroids after this latest UC flare up clears up and is considering 6MP, but she said she'll need to study it to determine if it's safe for PSC patients. We're in the process of switching Fred to a new liver doc, so can't get any help in that regard until he's seen. By the way, I've decided that good things do NOT come in 3's, as noted by my sign off! Wife of Fred, PSC 03/04, UC 03/06, Pancreatitis, BUBBA, UC Flare 03/09 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Suzanne was on 6MP for a long time for her UC, they kept a close eye on her liver, but we were doing that for the PSC anyway.Good luckLINDASent via BlackBerry from T-MobileFrom: Hussey Date: Wed, 25 Mar 2009 09:26:12 -0400To: < >Subject: 6MP for UC? Anyone tried 6MP for UC? Fred's gastro doesn't want to keep him on steroids after this latest UC flare up clears up and is considering 6MP, but she said she'll need to study it to determine if it's safe for PSC patients. We're in the process of switching Fred to a new liver doc, so can't get any help in that regard until he's seen. By the way, I've decided that good things do NOT come in 3's, as noted by my sign off! Wife of Fred, PSC 03/04, UC 03/06, Pancreatitis, BUBBA, UC Flare 03/09 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 , I was on it for years. I could not tolerate imuran or any other uc treatment. I did have to stop it after five or more years because of low RBC WBC Hematicrit and Hemaglobin. My UC is in remission now. I had no other side effects from 6-mp. I hope it can work as well for Fred. I'm sorry for all your new trials. You are both in my prayers. Take care, Cheryl ID 6MP for UC? > > Anyone tried 6MP for UC? Fred's gastro doesn't want to keep him on steroids after this latest UC flare up clears up and is considering 6MP, but she said she'll need to study it to determine if it's safe for PSC patients. We're in the process of switching Fred to a new liver doc, so can't get any help in that regard until he's seen. > > By the way, I've decided that good things do NOT come in 3's, as noted by my sign off! > > > Wife of Fred, PSC 03/04, UC 03/06, Pancreatitis, BUBBA, UC Flare 03/09 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 , I was on it for years. I could not tolerate imuran or any other uc treatment. I did have to stop it after five or more years because of low RBC WBC Hematicrit and Hemaglobin. My UC is in remission now. I had no other side effects from 6-mp. I hope it can work as well for Fred. I'm sorry for all your new trials. You are both in my prayers. Take care, Cheryl ID 6MP for UC? > > Anyone tried 6MP for UC? Fred's gastro doesn't want to keep him on steroids after this latest UC flare up clears up and is considering 6MP, but she said she'll need to study it to determine if it's safe for PSC patients. We're in the process of switching Fred to a new liver doc, so can't get any help in that regard until he's seen. > > By the way, I've decided that good things do NOT come in 3's, as noted by my sign off! > > > Wife of Fred, PSC 03/04, UC 03/06, Pancreatitis, BUBBA, UC Flare 03/09 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Hi , I was on 6MP for almost 4years - it is an amazing drug as far as controlling UC (in my case anyway)i couldnt stay of the steriods so tried this as alternative to azathioprine (6mp is the same part from one or two ingredients). It really worked and didnt use steriods the whole time - however the side effects are a lowered white cell count which needs careful monitoring i.e monthly blood tests. As a knock on from this you need watch out for infections as these will be even more potent due to the lack of white cells. Other than that i didnt have any probs. I've had to come off it now because my body couldnt handle being on it for soo long and so couldnt shake a chest infection. Hope this is of some use, (UK) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 Hi , I was on 6MP for almost 4years - it is an amazing drug as far as controlling UC (in my case anyway)i couldnt stay of the steriods so tried this as alternative to azathioprine (6mp is the same part from one or two ingredients). It really worked and didnt use steriods the whole time - however the side effects are a lowered white cell count which needs careful monitoring i.e monthly blood tests. As a knock on from this you need watch out for infections as these will be even more potent due to the lack of white cells. Other than that i didnt have any probs. I've had to come off it now because my body couldnt handle being on it for soo long and so couldnt shake a chest infection. Hope this is of some use, (UK) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 25, 2009 Report Share Posted March 25, 2009 My daughter is on 6mp and she has UC/PSC/AIH. Shes been on it since December, Dr. said it takes 3 months to work, so we will see. Feeling the pinch at the grocery store? Make dinner for $10 or less. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2009 Report Share Posted March 26, 2009 Dave and others, thanks SO much for your valuable info regarding the articles and your experiences with 6MP. I'll be posting another request for anyone's experiences with Remicade, as that is the other med the gastro is considering. Wife of Fred PSC, 03/04, UC 03/06, blah blah....03/09 Quote Link to comment Share on other sites More sharing options...
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