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See Latest ArticlesMethylenetetrahydrofolate reductase polymorphisms and methotrexate: No association with response to therapy nor with drug-related adverse events in an Italian population of rheumatic patients
Clinical and Experimental Rheumatology Online, 07/30/09
Taraborelli M et al. – It has been suggested that common polymorphisms in MTHFR gene could be related to different methotrexate (MTX) response and toxicity in rheumatoid arthritis (RA) patients. However, this study does not find any association between MTHFR genotype/allele and MTX response or toxicity; there is not sufficient evidence for MTHFR screening in pts who are candidate for MTX.
Methods- Aim was to determine if a genetic screening can help in planning the treatment in RA pts
- 84 Northern Italian pts affected by RA (n=79), psoriatic arthritis (n=4) and ankylosing spondylitis (n=1), who received MTX
- Subjects who achieved at least ACR20 response in 6 mo and maintained it during the following 6 mo were defined as “responders”
- Those who did not obtain a disease control after 6 mo of MTX were classified as “non responders”
- Pts who experienced MTX AEs were defined “with toxicity”
- Those who did not, as “without toxicity”
- Genotypes were determined by PCR
- Genotype frequency was consistent with that reported in a healthy population from Italy
- No significant difference in genotype/allele distribution between the groups
- In pts receiving folic acid supplementation MTX toxicity was recorded only in 18 cases (24%)
- While all 8 pts not receiving it experienced MTX adverse events
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