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Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. Here’s a preview of a recent popular clinical discussion:

Junaid Beig, MBBS, FRACP wrote the following in “Subtherapeutic Azathioprine metabolites despite being adherent to medication”:

“I have an Ulcerative patient (Pancolitis) on Mesalazine and Azathioprine 150mg since 2018. His levels are subtherapeutic (6TGN 159 and 6MMP 70) despite being adherent to medication. He drinks 2 liters of wine per week.

“Questions: Is there any way we can find if he has high TPMT activity (Level is normal 6.1)? Does alcohol have an impact on TPMT activity? Does he warrant alternative treatment?”

See how AGA members responded and join the discussion: https://community.gastro.org/posts/25109.

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