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We read with interest the article by Furukawa et al1 suggesting an association between HLA-A 31:01 and methotrexate (MTX)-induced interstitial lung disease (ILD) in Japanese patients with rheumatoid arthritis (RA). MTX-ILD or MTX-pneumonitis (MTX-P) is an idiosyncratic hypersensitivity reaction to MTX that usually occurs within the first year of MTX therapy, inducing inflammation, cytokine release and the activation of CD4+ T-lymphocytes within the lung parenchyma,2–4 with a reported prevalence of 1% of the Caucasian RA population prescribed MTX.5
To investigate this association further, we conducted a genome-wide association study. Rheumatologists working within the National Health Service in the UK identified Caucasian patients …
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