{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:16:22Z","timestamp":1791483382670,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T00:00:00Z","timestamp":1632528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2020M683139"],"award-info":[{"award-number":["2020M683139"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Thiopurine S\u2010methyltransferase (TPTM) is a well known biomarker for thiopurine\u2010induced leucopenia, which has limited value in Asia. Instead, <jats:italic>NUDT15<\/jats:italic> C415T is a promising predictor in Asia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To explore whether an optimised strategy based on <jats:italic>NUDT15<\/jats:italic> C415T genotypes affects thiopurine\u2010induced leucopenia, as well as efficacy in Chinese patients with Crohn's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with Crohn's disease and indications for thiopurines were included from two hospitals in China. They were randomly assigned to either the intervention or the control group. In the intervention group, those with genotype CC received a standard dose (control group), those with CT genotype received 50% of the standard dose, those with TT genotype received alternative drugs. The primary endpoint was thiopurine\u2010induced leucopenia (&lt;3.5\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L). Secondary outcomes were the incidence of other adverse events and the efficacy for maintaining steroid\u2010free remission at week 36.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rate of thiopurine\u2010induced leucopenia was lower in the intervention group (n\u00a0=\u00a052) than in the control group (n\u00a0=\u00a066) (23.7% vs 32.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.049, RR\u00a0=\u00a00.73, 95% CI 0.53\u20101.00). In CT subgroup, the incidence of leucopenia in the intervention group (n\u00a0=\u00a010) was significantly lower than in the control group (n\u00a0=\u00a028) (31.3% vs 65.1%, RR\u00a0=\u00a00.48, 95% CI 0.28\u20100.84). Neither other adverse events nor treatment efficacy was significantly different between the two groups during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among Chinese patients with Crohn's disease, dose optimisation by <jats:italic>NUDT15<\/jats:italic> C415T reduced the rate of thiopurine\u2010induced leucopenia, without significant influence on efficacy. Using 50% dose reduction for heterozygotes, and alternative drugs for homozygotes, are practicable strategies.<\/jats:p><jats:p>Clinical trial number: NCT02929706.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16600","type":"journal-article","created":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T21:14:30Z","timestamp":1632604470000},"page":"1124-1133","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Randomised clinical trial: dose optimising strategy by <i>NUDT15<\/i> genotyping reduces leucopenia during thiopurine treatment of Crohn's disease"],"prefix":"10.1111","volume":"54","author":[{"given":"Kang","family":"Chao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology The Sixth Affiliated Hospital Sun Yat\u2010sen University Guangzhou China"},{"name":"Guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National 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