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Mesalazine monitoring — GPhC CRA MCQ

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HardGI TherapeuticsMesalazine monitoringGPhC CRA

A patient with inflammatory bowel disease is due to start azathioprine. Which pretreatment result helps identify markedly increased thiopurine myelotoxicity risk?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: AThiopurine methyltransferase activity or genotype before the first dose

Absent or very low TPMT activity creates a high risk of profound myelosuppression with standard azathioprine dosing; reduced activity requires substantial dose adjustment. Testing does not replace ongoing FBC, liver and renal monitoring because toxicity can still occur with normal TPMT.

Reference: BNF: azathioprine: https://bnf.nice.org.uk/drugs/azathioprine/