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Tumor Necrosis Factor-a Receptor II Polymorphism in Patients from Southern Europe with Mild-Moderate and Severe Rheumatoid Arthritis
MARTINA FABRIS, BARBARA TOLUSSO, EMMA DI POI, ROBERTA ASSALONI, LUIGI SINIGAGLIA, and GIANFRANCO FERRACCIOLI
ABSTRACT.
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-a 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-a 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-a 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-a treatments in patients carrying the G allele. (J Rheumatol 2002;29:1847-50) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Division of Rheumatology, DPMSC School of Medicine, University of Udine, Udine; and the Department of Rheumatology, School of Medicine of Milan, Milan, Italy. M. Fabris, MD; B. Tolusso, MD; E. Di Poi, MD; R. Assaloni, MD; L. Sinigaglia, MD; G.F. Ferraccioli, MD, Professor, Director, Division of Rheumatology, DPMSC School of Medicine. Address reprint requests to Dr. G.F. Ferraccioli, Division of Rheumatology, DPMSC School of Medicine, University of Udine, 33100 Udine, Italy. E-mail: gf.ferraccioli@med.uniud.it Submitted October 22, 2001; revision accepted March 4, 2002.
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