1. Tumor necrosis factor-alpha receptor II polymorphism in patients from southern Europe with mild-moderate and severe rheumatoid arthritis.
- Author
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Fabris M, Tolusso B, Di Poi E, Assaloni R, Sinigaglia L, and Ferraccioli G
- Subjects
- Adult, Age Distribution, Aged, Aged, 80 and over, Arthritis, Rheumatoid epidemiology, Case-Control Studies, Drug Therapy, Combination, Female, Genotype, Humans, Incidence, Italy epidemiology, Male, Middle Aged, Odds Ratio, Pharmacogenetics, Probability, Prognosis, Receptors, Tumor Necrosis Factor, Type II, Reference Values, Retrospective Studies, Risk Factors, Severity of Illness Index, Sex, Sex Distribution, Treatment Outcome, Antigens, CD genetics, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid genetics, Genetic Predisposition to Disease, Methotrexate therapeutic use, Polymorphism, Genetic, Prednisone therapeutic use, Receptors, Tumor Necrosis Factor genetics
- Abstract
Objective: To define the frequency of the exon 6 tumor necrosis factor-alpha (TNF-alpha) receptor II (TNFRII) gene polymorphism in severe and mild-moderate rheumatoid arthritis (RA) and its possible influence on anti-TNF-alpha treatment responsiveness., Methods: Two cohorts of patients with RA, the first (n = 97) defined as methotrexate responders (MTX-R) with mild-moderate synovitis, and the second (n = 78) defined as nonresponders to combination therapy and receiving anti-TNF-alpha treatment because of their severe and aggressive disease (TNF-T), were studied retrospectively and compared to age, sex, and ethnically matched controls (n = 84). In the prospective study, 66 patients with severe RA were followed over the first 6 months of anti-TNF-alpha therapy and their response was examined according to genotype., Results: We observed a trend towards an increased frequency of the GG genotype in patients with severe RA (6.4%) in comparison with patients with mild-moderate disease (3.1%) and controls (1.2%). When looking at the response to anti-TNF-alpha therapy, we observed that after 12 weeks of treatment, 37.8% of the TT versus 10.7% of the TG/GG patients passed from high to medium-low disease activity (p = 0.03)., Conclusion: In our cohorts of patients selected by response to the conventional therapy and by disease severity, our preliminary study results showed a trend towards a higher prevalence of the GG genotype for the exon 6 TNFRII polymorphism in the less responsive patients with more aggressive disease. We also found a lower degree of response to anti-TNF-alpha treatments in patients carrying the G allele.
- Published
- 2002