Lack of association between HLA-G 14 bp insertion/deletion polymorphism and response to long-term therapy with methotrexate response in rheumatoid arthritis

L K Stamp^1,2, J L O’Donnell¹, P T Chapman¹, M L Barclay³, M A Kennedy⁴, C M A Frampton², R L Roberts⁴

¹ Department of Rheumatology, Immunology and Allergy, Christchurch Hospital, Christchurch, New Zealand
² Department of Medicine, University of Otago, Christchurch, New Zealand
³ Department of Clinical Pharmacology, Christchurch Hospital, Christchurch, New Zealand
⁴ Department of Pathology, University of Otago, Christchurch, New Zealand

Correspondence to:
L K Stamp, Department of Medicine, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand; lisa.stamp@cdhb.govt.nz

Accepted 6 April 2008

The first 150 words of the full text of this article appear below.

Pharmacogenetic studies examining methotrexate (MTX) response/toxicity have focused on enzymes involved in MTX transport and folate metabolism.¹ However, recently it has been reported that patients with rheumatoid arthritis (RA) with the HLA-G –/–14 bp genotype are more likely to respond to MTX.^{2 3} Human leukocyte antigen (HLA)-G molecules are non-classical major histocompatability complex (MHC) class I antigens that play a role in the immune system.⁴

We investigated whether an association exists between the HLA-G –/–14 bp polymorphism and response to MTX in a cross-sectional study of patients with RA. Of the 130 patients recruited, 75.4% were female, 81% were rheumatoid factor (RF) positive and 67% had erosions. Patients were defined as responders based on a 28-joint Disease Activity Score (DAS28) of 3.2, or non-responders if DAS28>3.2. Accordingly, 63% were responders and 27% non-responders. The dose of MTX was significantly higher in non-responders compared to responders (16.6 mg/week vs 14.8 mg/week; p . . . [Full text of this article]

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