Prediction of Thiopurine Metabolite Levels Based on Haematological and Biochemical Parameters.
J Pediatr Gastroenterol Nutr
; 69(4): e105-e110, 2019 10.
Article
en En
| MEDLINE
| ID: mdl-31568041
ABSTRACT
OBJECTIVES:
Therapeutic drug monitoring of thiopurine erythrocyte levels is not available in all centers and it usually requires quite a long time to obtain the results. The aims of this study were to build a model predicting low levels of 6-thioguanine and 6-methylmercaptopurine in pediatric inflammatory bowel disease (IBD) patients and to build a model to predict nonadherence in patients treated with azathioprine (AZA).METHODS:
The study consisted of 332 observations in 88 pediatric IBD patients. Low AZA dosing was defined as 6-thioguanine levels <125âpmol/8â×â10 erythrocytes and 6-methylmercaptopurine levels <5700âpmol/8â×â10 erythrocytes. Nonadherence was defined as undetectable levels of 6-thioguanine and 6-methylmercaptopurine <240âpmol/8â×â10 erythrocytes. Data were divided into training and testing part. To construct the model predicting low 6-thioguanine levels, nonadherence, and the level of 6-thioguanine, the modification of random forest method with cross-validation and resampling was used.RESULTS:
The final models predicting low 6-thioguanine levels and nonadherence had area under the curve, 0.87 and 0.94; sensitivity, 0.81 and 0.82; specificity, 0.80 and 86; and distance, 0.31 and 0.21, respectively, when applied on the testing part of the dataset. When the final model for prediction of 6-thioguanine values was applied on testing dataset, a root-mean-square error of 110 was obtained.CONCLUSIONS:
Using easily obtained laboratory parameters, we constructed a model with sufficient accuracy to predict patients with low 6-thioguanine levels and a model for prediction of AZA treatment nonadherence (web applications https//hradskyo.shinyapps.io/6TG_prediction/ and https//hradskyo.shinyapps.io/Non_adherence/).
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Enfermedades Inflamatorias del Intestino
/
Cumplimiento de la Medicación
/
Inmunosupresores
/
Mercaptopurina
Tipo de estudio:
Diagnostic_studies
/
Evaluation_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Año:
2019
Tipo del documento:
Article