TY - JOUR T1 - HLA-DRB1 typing in rheumatoid arthritis: predicting response to specific treatments JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 209 LP - 213 DO - 10.1136/ard.57.4.209 VL - 57 IS - 4 AU - James R O’Dell AU - Barbara S Nepom AU - Claire Haire AU - Vivian H Gersuk AU - Lakshmi Gaur AU - Gerald F Moore AU - Walter Drymalski AU - William Palmer AU - P James Eckhoff AU - Lynell W Klassen AU - Steven Wees AU - Geoffrey Thiele AU - Gerald T Nepom Y1 - 1998/04/01 UR - http://ard.bmj.com/content/57/4/209.abstract N2 - OBJECTIVE To determine the predictive value of shared epitope alleles for response to treatment in patients with rheumatoid arthritis. METHODS Patients from our previously published triple DMARD study were tested for the presence of shared epitope alleles (DRB1 *0401,0404/0408, 0405,0101, 1001,and 1402). Patients who were shared epitope positive were then compared with those who were negative to see if there was a differential effect on therapeutic response. RESULTS Shared epitope positive patients were much more likely to achieve a 50% response if treated with methotrexate-sulphasalazine-hydroxychloroquine compared with methotrexate alone (94% responders versus 32%, p<0.0001). In contrast shared epitope negative patients did equally well regardless of treatment (88% responders for methotrexate-sulphasalazine-hydroxychloroquine versus 83% for methotrexate). Additionally, a trend toward an inverse relation of the gene dose was seen for response to methotrexate treatment (p=0.05). CONCLUSIONS These data suggest that determining shared epitope status may provide clinical information useful in selecting among treatment options. ER -