Objectives To assess the prevalence of TNF-alpha polymorphisms in patients with early rheumatoid arthritis (RA) in our population and investigate whether there is an association with radiographic severity.
Methods 68 patients with early RA (49F/19M, mean age 51 ± 15 y, mean disease duration 15 ± 13 mo, RF+ 72%, mean number of tender joints at entry 6.3 ± 5.7, mean number of swollen joints at entry 8.23 ± 7.33). Patients were genotyped for HLA-DRB1 and TNF-alpha alleles. Hands and feet radiographs were taken at entry and then yearly during follow-up. The Larsen method was used to assess radiographic damage.
Results There were not differences in the distribution of TNF-alpha alleles in the RA patients compared with controls. The TNF-alpha -308GG genotype instead of the ?308GA genotype was found to be more frequent in patients with no erosive disease at entry compared with those presenting erosions (89% vs 62%, p = 0.0023). Patients not showing radiographic erosions during follow-up (36.5 ± 22 mo) also had more frequently the -308GG genotype (96% vs. 74% in erosive disease, p = 0.018). There were no differences in disease duration nor follow-up between patients with erosive and non erosive disease. The TNF-alpha -308GG polymorphism was as frequent in patients with non erosive disease as in controls, and there were not differences either among RF+ve and RF-ve patients nor among patients with or without the shared epitope or who were HLA-DR4 positive. No other associations related to TNF-alpha were found in relation to radiographic damage.
Conclusion The presence of the ?308GG TNF-alpha genotype appears to be one of the factors related to less severe disease as determined by erosive disease, and may have a protective role compared with the ?308 GA genotype.
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