{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:16:29Z","timestamp":1792196189449,"version":"4.4.0"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Thiopurine methyltransferase (TPMT) and Nudix hydrolase 15 (NUDT15) are key enzymes that catabolize thiopurines. Decreased or no\u2010function alleles in\n                    <jats:italic>TPMT<\/jats:italic>\n                    and\n                    <jats:italic>NUDT15<\/jats:italic>\n                    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\n                    <jats:italic>TPMT<\/jats:italic>\n                    and\n                    <jats:italic>NUDT15<\/jats:italic>\n                    genotypes, including for individuals with variants in both genes (updates on\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.cpicpgx.org\">www.clinpgx.org<\/jats:ext-link>\n                    ).\n                  <\/jats:p>","DOI":"10.1002\/cpt.70209","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T15:07:18Z","timestamp":1769872038000},"page":"916-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Thiopurine Dosing Based on\n                    <i>TPMT<\/i>\n                    and\n                    <i>NUDT15<\/i>\n                    Genotypes: 2025 Update"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6615-3136","authenticated-orcid":false,"given":"Maud","family":"Maillard","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Sciences St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"},{"name":"Univ Toulouse, Oncopole Claudius Regaud Centre de Recherches en Canc\u00e9rologie de Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9984-075X","authenticated-orcid":false,"given":"Matthias","family":"Schwab","sequence":"additional","affiliation":[{"name":"Dr Margarete Fischer\u2010Bosch Institute of Clinical Pharmacology  Stuttgart Germany"},{"name":"Department of Clinical Pharmacology, Institute of Experimental and Clinical Pharmacology and Toxicology University Hospital  Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2414-9312","authenticated-orcid":false,"given":"Michelle","family":"Whirl\u2010Carrillo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Science Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2590-7218","authenticated-orcid":false,"given":"Ann M.","family":"Moyer","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-8319","authenticated-orcid":false,"given":"Guilherme","family":"Suarez\u2010Kurtz","sequence":"additional","affiliation":[{"name":"Instituto Nacional de C\u00e2ncer Rio de Janeiro, Brazil Brazilian Pharmacogenomics Network  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Hon","family":"Pui","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Michael","family":"Stein","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-6475","authenticated-orcid":false,"given":"Teri E.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Science Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6426-022X","authenticated-orcid":false,"given":"Claire","family":"Spahn","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Stanford Health Care  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sooyeon","family":"Kwon","sequence":"additional","affiliation":[{"name":"Samuel S. Stratton Department of Veterans Affairs Medical Center  Albany New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanda Leo","family":"Hartono","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology National University Hospital  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanne K.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam University Medical Centre, Vrije Universiteit Amsterdam  Amsterdam HV The Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam University Medical Centre  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Royal Devon University Healthcare NHS Foundation Trust  Exeter UK"},{"name":"University of Exeter Medical School  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico Guillermo","family":"Antillon\u2010Klussmann","sequence":"additional","affiliation":[{"name":"National Pediatric Oncology Unit, School of Medicine, Francisco Marroquin University  Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5663-3793","authenticated-orcid":false,"given":"Kelly E.","family":"Caudle","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5145-1774","authenticated-orcid":false,"given":"Motohiro","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen E. 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