Lupus & antiphospholipid syndrome
Azathioprine metabolite levels and outcomes during pregnancies with rheumatic disease
Authors' conclusion
In this exploratory study, we did not observe systematic changes in 6-TGN concentrations throughout pregnancy and peripartum, whereas 6-MMPN concentrations were higher during pregnancy.
Study context
- Population
- Women with rheumatic disease prescribed AZA prior to pregnancy with ≥1 blood sample during pregnancy, single centre (5/2016 to 4/2022)
- Participants
- 35 women37 pregnancies
- Outcome
- Changes in AZA metabolite (6-TGN, 6-MMPN) concentrations throughout pregnancy
Methodological detailssingle-centre, exploratory
- Single-centre
- Exploratory
Main finding
As reported in the abstract
AZA metabolite concentrations across pregnancy
- No significant difference in dose-adjusted 6-TGN concentrations across pregnancy and peripartum
- 6-MMPN concentrations appeared higher during pregnancy
- Metabolite concentrations related to total AZA dosage, weight-based dosage and TPMT phenotype
- Exploratory study
Observational data: associations, not effects.
Further findings
SLE pregnancies with average 6-TGN in therapeutic range: Physician Global Assessment (PGA) and neonatal gestational age at birth
- Non-significant reduction in PGA and increase in neonatal gestational age at birth
Safety
Elevated transaminases or cholestasis concurrent with 6-MMPN above 5700 pmol/8×108 RBC
- No elevated transaminases or cholestasis observed concurrently with 6-MMPN above 5700 pmol/8×108 RBC
Original publication
Azathioprine metabolite levels and outcomes during pregnancies with rheumatic disease. Lupus Sci Med. Published 3 January 2024. doi:10.
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