Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in Japan
The usefulness of NUDT15 genotyping as a pharmacogenomic test for thiopurine has been established. The first such test developed to date, NUDT15 genotyping was approved for reimbursement in Japan in February 2019 for all indicated patients. We retrospectively examined claims data in Japan and confir...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-11-01
|
| Series: | Journal of Pharmacological Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1347861323000555 |
| _version_ | 1797672115202162688 |
|---|---|
| author | Yoichi Kakuta Motohiro Kato Yusuke Shimoyama Takeo Naito Rintaro Moroi Masatake Kuroha Hisashi Shiga Yoshitaka Kinouchi Atsushi Masamune |
| author_facet | Yoichi Kakuta Motohiro Kato Yusuke Shimoyama Takeo Naito Rintaro Moroi Masatake Kuroha Hisashi Shiga Yoshitaka Kinouchi Atsushi Masamune |
| author_sort | Yoichi Kakuta |
| collection | DOAJ |
| description | The usefulness of NUDT15 genotyping as a pharmacogenomic test for thiopurine has been established. The first such test developed to date, NUDT15 genotyping was approved for reimbursement in Japan in February 2019 for all indicated patients. We retrospectively examined claims data in Japan and confirmed that the proportion of patients who undergo genotyping before initiating a new thiopurine regimen has increased; furthermore, genotyping has improved the rate of treatment continuation and reduced on-treatment hospitalization. However, the genotyping rate before thiopurine induction was >50% for patients with inflammatory bowel disease and <20% for those with other immune-related diseases, indicating significant variation by disease field. Additionally, over 10% of tests were found to have been performed inappropriately, such as multiple genotyping of the same patient or testing more than 2 weeks after starting treatment. Although NUDT15 genotyping for patients requiring thiopurine treatment has been shown to improve thiopurine treatment continuation rate, measures are required to address the systematic issues identified in our analysis. |
| first_indexed | 2024-03-11T21:25:23Z |
| format | Article |
| id | doaj.art-f0a387ae9651457ab87e912b9f263c72 |
| institution | Directory Open Access Journal |
| issn | 1347-8613 |
| language | English |
| last_indexed | 2024-03-11T21:25:23Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pharmacological Sciences |
| spelling | doaj.art-f0a387ae9651457ab87e912b9f263c722023-09-28T05:25:04ZengElsevierJournal of Pharmacological Sciences1347-86132023-11-011533161169Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in JapanYoichi Kakuta0Motohiro Kato1Yusuke Shimoyama2Takeo Naito3Rintaro Moroi4Masatake Kuroha5Hisashi Shiga6Yoshitaka Kinouchi7Atsushi Masamune8Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan; Corresponding author. Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba, Sendai, 980-8574, Japan.Department of Pediatrics, University of Tokyo, Tokyo, JapanDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, JapanDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, JapanStudent Healthcare Center, Institute for Excellence in Higher Education, Tohoku University, Sendai, JapanDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, JapanThe usefulness of NUDT15 genotyping as a pharmacogenomic test for thiopurine has been established. The first such test developed to date, NUDT15 genotyping was approved for reimbursement in Japan in February 2019 for all indicated patients. We retrospectively examined claims data in Japan and confirmed that the proportion of patients who undergo genotyping before initiating a new thiopurine regimen has increased; furthermore, genotyping has improved the rate of treatment continuation and reduced on-treatment hospitalization. However, the genotyping rate before thiopurine induction was >50% for patients with inflammatory bowel disease and <20% for those with other immune-related diseases, indicating significant variation by disease field. Additionally, over 10% of tests were found to have been performed inappropriately, such as multiple genotyping of the same patient or testing more than 2 weeks after starting treatment. Although NUDT15 genotyping for patients requiring thiopurine treatment has been shown to improve thiopurine treatment continuation rate, measures are required to address the systematic issues identified in our analysis.http://www.sciencedirect.com/science/article/pii/S1347861323000555NUDT15PharmacogeneticsAzathioprine6-MelcaptopurineThiopurine |
| spellingShingle | Yoichi Kakuta Motohiro Kato Yusuke Shimoyama Takeo Naito Rintaro Moroi Masatake Kuroha Hisashi Shiga Yoshitaka Kinouchi Atsushi Masamune Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in Japan Journal of Pharmacological Sciences NUDT15 Pharmacogenetics Azathioprine 6-Melcaptopurine Thiopurine |
| title | Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in Japan |
| title_full | Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in Japan |
| title_fullStr | Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in Japan |
| title_full_unstemmed | Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in Japan |
| title_short | Usefulness and difficulties with the thiopurine pharmacogenomic NUDT15 genotyping test: Analysis of real-world data in Japan |
| title_sort | usefulness and difficulties with the thiopurine pharmacogenomic nudt15 genotyping test analysis of real world data in japan |
| topic | NUDT15 Pharmacogenetics Azathioprine 6-Melcaptopurine Thiopurine |
| url | http://www.sciencedirect.com/science/article/pii/S1347861323000555 |
| work_keys_str_mv | AT yoichikakuta usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT motohirokato usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT yusukeshimoyama usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT takeonaito usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT rintaromoroi usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT masatakekuroha usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT hisashishiga usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT yoshitakakinouchi usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan AT atsushimasamune usefulnessanddifficultieswiththethiopurinepharmacogenomicnudt15genotypingtestanalysisofrealworlddatainjapan |