TY - JOUR T1 - Genome-wide association analysis of anti-TNF drug response in patients with rheumatoid arthritis JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1375 LP - 1381 DO - 10.1136/annrheumdis-2012-202405 VL - 72 IS - 8 AU - Maša Umiċeviċ Mirkov AU - Jing Cui AU - Sita H Vermeulen AU - Eli A Stahl AU - Erik J M Toonen AU - Remco R Makkinje AU - Annette T Lee AU - Tom W J Huizinga AU - Renee Allaart AU - Anne Barton AU - Xavier Mariette AU - Corinne Richard Miceli AU - Lindsey A Criswell AU - Paul P Tak AU - Niek de Vries AU - Saedis Saevarsdottir AU - Leonid Padyukov AU - S Louis Bridges AU - Dirk-Jan van Schaardenburg AU - Tim L Jansen AU - Ellen A J Dutmer AU - Mart A F J van de Laar AU - Pilar Barrera AU - Timothy R D J Radstake AU - Piet L C M van Riel AU - Hans Scheffer AU - Barbara Franke AU - Han G Brunner AU - Robert M Plenge AU - Peter K Gregersen AU - Henk-Jan Guchelaar AU - Marieke J H Coenen Y1 - 2013/08/01 UR - http://ard.bmj.com/content/72/8/1375.abstract N2 - Background Treatment strategies blocking tumour necrosis factor (anti-TNF) have proven very successful in patients with rheumatoid arthritis (RA). However, a significant subset of patients does not respond for unknown reasons. Currently, there are no means of identifying these patients before treatment. This study was aimed at identifying genetic factors predicting anti-TNF treatment outcome in patients with RA using a genome-wide association approach. Methods We conducted a multistage, genome-wide association study with a primary analysis of 2 557 253 single-nucleotide polymorphisms (SNPs) in 882 patients with RA receiving anti-TNF therapy included through the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry and the database of Apotheekzorg. Linear regression analysis of changes in the Disease Activity Score in 28 joints after 14 weeks of treatment was performed using an additive model. Markers with p<10−3 were selected for replication in 1821 patients from three independent cohorts. Pathway analysis including all SNPs with p<10−3 was performed using Ingenuity. Results 772 markers showed evidence of association with treatment outcome in the initial stage. Eight genetic loci showed improved p value in the overall meta-analysis compared with the first stage, three of which (rs1568885, rs1813443 and rs4411591) showed directional consistency over all four cohorts studied. We were unable to replicate markers previously reported to be associated with anti-TNF outcome. Network analysis indicated strong involvement of biological processes underlying inflammatory response and cell morphology. Conclusions Using a multistage strategy, we have identified eight genetic loci associated with response to anti-TNF treatment. Further studies are required to validate these findings in additional patient collections. ER -