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AB0311 The 158vv fcgamma receptor iiia genotype predicts a positive response to rituximab in rheumatoid arthritis: Analysis in a large cohort of italian patients
  1. M. Fabris1,
  2. L. Quartuccio2,
  3. E. Pontarini2,
  4. A. Zabotti2,
  5. M. Benucci3,
  6. M. Manfredi3,
  7. D. Biasi4,
  8. V. Ravagnani4,
  9. F. Atzeni5,
  10. P. Morassi6,
  11. F. Fischetti7,
  12. L. Bazzicchi8,
  13. M. Saracco9,
  14. R. Pellerito9,
  15. M. Cimmino10,
  16. V. Carraro11,
  17. A. Semeraro12,
  18. R. Caporali13,
  19. L. Cavagna13,
  20. R. Bortolotti14,
  21. M. Govoni15,
  22. S. Bombardieri8,
  23. S. De Vita2
  1. 1Laboratory Medicine, University Hospital of Udine
  2. 2Rheumatology Clinic, University of Udine, Udine
  3. 3Rheumatology Clinic, Ospedale San Giovanni di Dio, Firenze
  4. 4Rheumatology Clinic, University of Verona, Verona
  5. 5Rheumatology Clinic, Ospedale L. Sacco, Milano
  6. 6Internal Medicine, Ospedali Riuniti of Trieste
  7. 7Internal Medicine, University of Trieste, Trieste
  8. 8Internal Medicine, University of Pisa, Pisa
  9. 9Unit of Rheumatology, Ospedale Mauriziano, Torino
  10. 10Rheumatology Clinic, University of Genova, Genova
  11. 11Rheumatology Clinic, University of Padova, Padova
  12. 12Unit of Rheumatology, Ospedale Valle D’Itria, Martina Franca (TA)
  13. 13Unit of Rheumatology, Ospedale S.Matteo, Pavia
  14. 14Unit of Rheumatology, Santa Chiara Hospital, Trento
  15. 15Clinic of Rheumatology, University of Ferrara, Ferrara, Italy

Abstract

Background Receptors for IgG play an important part in immune complex clearance. Several studies have investigated the polymorphism 158V/F of Fc fragment of IgG (FcgR) type IIIa as genetic factor influencing disease course after rituximab (RTX) therapy in several rheumatologic and haematological diseases, with contrasting, unreplicated results.

Objectives To investigate the FcgRIIIa 158V/F polymorphism in a large Italian retrospective cohort of patients with rheumatoid arthritis treated with RTX.

Methods The study was conducted in 222 unselected RA patients referred to 13 rheumatologic centres in Italy. All patients were treated with RTX (alone or in combination with DMARDs) at standard doses. Response to therapy (DAS28; EULAR criteria) was evaluated at months +4 (data available in 213 cases) and +6 (data available in all cases) after the first RTX infusion. The FcgRIIIa polymorphism was analysed by PCR followed by Sanger’s sequencing.

Results Patients with the VV genotype showed the highest rate of response to RTX both at month +4 (good/moderate in 32/37, 86.5% of the VV patients) and at month +6 (good/moderate response in 34/38, 89.5% of the VV patients) while VF and FF patients showed the same response rate either at month +4 (good/moderate in 70/103, 68% VF and in 53/73, 72.6% FF patients; VV versus VF/FF: OR 2.76, 95%CI 1.02-7.47, *p=0.043) and at month +6 (good/moderate in 69/105, 65.7% VF and in 49/75, 65.3% FF patients; VV versus VF/FF: OR 4.47, 95%CI 1.52-13.16, **p=0.0032).

Conclusions The VV genotype of the 158V/F FcgRIIIa polymorphism identifies RA patients who demonstrate the highest rate of positive response to RTX. By contrast, no difference was noticed between VF and FF patients.

Disclosure of Interest None Declared

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