Severance Hospital researchers have found a new way to reduce the adverse effects of purine-based immune-modulators in treating inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease.

Professor Cheon Jae-hee (left) and Professor Kim Won-ho

Immune-modulators are a necessary treatment for IBD. However, immune-modulators can sometimes have the side effect of reducing white blood cells and neutrophils due to bone marrow suppression. Such adverse effects bring discomfort and anxiety to patients as they have to undergo blood tests frequently.

To resolve such issues, the team, led by Professors Cheon Jae-hee and Kim Won-ho, developed a method where the hospital can determine the use and dosage of purine-based immune-modulators based on the genetic test results of patients with IBD to reduce side effects.

The researchers classified patients treated at five university hospitals in Seoul for IBD from January 2016 to September 2018 into two groups -- the genetic mutation measuring group (72) and non-measuring group (92). Afterward, they observed the frequency of adverse events such as myelosuppression.

The study found that only 12 patients (16.7 percent) had side effects of bone marrow suppression in the genetic mutation measuring group, compared to 33 patients (35.9 percent) who developed bone marrow suppression side effects in the genetic mutation non-measuring group.

The two groups showed significant differences, indicating that immune-modulatory administration through measuring genetic mutation was effective in preventing side effects of bone marrow suppression.

The use of immune-modulators through measuring genetic mutation has also shown that they reduce the rate of discontinuing drugs or reducing dosage because of the number of hospital visits and side effects.

"Purine-based immune-modulators are the most effective and commonly used drugs for treating IBD," Professor Cheon said. "However, side effects, such as bone marrow suppression, increased psychological anxiety in patients."

The study proved that genetic test results of individual patients could improve the treatment effect as hospitals can control the dose of the drug thereby reducing the bone marrow suppression symptoms such as white blood cell reduction, Cheon added.

The team published the results of the research in the Clinical Gastroenterology and Hepatology, under the title "Genotype-based treatment with thiopurine reduces the incidence of myelosuppression in patients with inflammatory bowel diseases."

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