Purpose: Genotypes that result in deficient activity of the thiopurine-methyltransferase (TPMT) enzyme may confer increased risk of myelosuppression for patients treated with azathioprine. TPMT is essential to the metabolism of azathioprine and is involved in the folic acid metabolism pathway. Therefore, we propose the dietary folic acid supplementation mitigates azathioprine-induced myelosuppression irrespective of TPMT genotype. Hypothesis: Folic acid supplementation mitigates azathioprine-induced myelosuppression in pediatric IBD.

Primary Outcome: 

  • Discern if folic acid supplementation mitigates azathioprine-induced myelosuppression

Secondary Outcome: 

  • Discern how many patients receive folic acid supplementation in addition to azathioprine treatment.
  • Discern the TPMT genotype and phenotype of patients with IBD who develop myelosuppression while on azathioprine

Funding Source: Center for Undergraduate Excellence, Chapman University

Study Period: June 2019- May 2020

Recruitment Status: This study makes use of existing data in the ICN registry. No patient recruitment at this time.

Contact: John Miklavcic; (714-516-5520) 

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