Medline ® Abstract for Reference 115
of 'HLA and other susceptibility genes in rheumatoid arthritis'
115
TI
HLA-DRB1 typing in rheumatoid arthritis: predicting response to specific treatments.
AU
O'Dell JR, Nepom BS, Haire C, Gersuk VH, Gaur L, Moore GF, Drymalski W, Palmer W, Eckhoff PJ, Klassen LW, Wees S, Thiele G, Nepom GT
SO
Ann Rheum Dis. 1998;57(4):209.
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.
AD
Department of Internal Medicine, University of Nebraska Medical Center (UNMC), USA.
PMID