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Ann Rheum Dis 65:1121-1123 doi:10.1136/ard.2006.051789
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Methotrexate pharmacogenomics

Table 1

 MTHFR genotyping: published literature

Author Objective/study design n Polymorphisms Treatment regimens Results
BMT, bone marrow transplant; CML, chronic myelogenous leukaemia; DB, double blind; MTHFR, methylene tetrahydrofolate reductase; MTX, methotrexate; PC, placebo controlled; RA, rheumatoid arthritis.7–9
Ulrich et al9 C677T modification of response to MTX Retrospective 220 CML BMT TT = 16%CT = 42% CC = 42% MTX intravenous ×4 doses Folate/folic acid unknown TT genotype associated with ↑ toxicity (mucositis, ↓ platelet recovery)
Van Ede et al7 Relationship between C677T and efficacy and toxicity of MTX 236 RA TT = 8% CT = 40% CC = 52% MTX MTX and folate MTX and folic acid T/T and T/C genotypes associated with ↑ toxicity and MTX discontinuation
Prospective, DB, PC
Urano et al8 C677T and A1298T association with MTX efficacy and toxicity Retrospective 106 RA TT = 17% CT = 50% CC = 33% AC = 27% CC = 3% MTX doses variable(MTX treatment had been discontinued in some patients) Folic acid not given in most cases Prevalence of polymorphisms was reported to be associated with both MTX efficacy and toxicity T at C677T and C at A1298C—toxicity

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