Arthritis Research UK Centre of Excellence for Musculoskeletal Genetics, Manchester Academy of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK.
School of Medicine & Medical Science, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.
Nat Rev Rheumatol. 2014 Jun;10(6):329-37. doi: 10.1038/nrrheum.2014.16. Epub 2014 Feb 18.
Methotrexate and TNF-blocking agents are the DMARDs most commonly prescribed for the treatment of rheumatoid arthritis (RA). However, not all patients treated with these nonbiologic and biologic DMARDs respond satisfactorily and few predictors of treatment efficacy have been identified, despite the fact that these therapies have now been available for many years. Many studies have investigated genetic factors that might predict patient responsiveness to therapies used to treat RA, and epigenetic studies regarding response to treatment are expected to accumulate in the literature in the near future. Herein, we review the advances in identifying genetic and epigenetic predictors of therapeutic responses to methotrexate and/or TNF inhibitors in RA that have been made to date, and highlight important considerations for future studies, such as the need for an improved, preferably biological, outcome measure reflecting response to treatment.
甲氨蝶呤和 TNF 阻滞剂是最常用于治疗类风湿关节炎 (RA) 的 DMARDs。然而，并非所有接受这些非生物和生物 DMARDs 治疗的患者都能得到满意的反应，尽管这些治疗方法已经使用了多年，但很少有治疗效果的预测因素被确定。许多研究调查了可能预测患者对用于治疗 RA 的治疗反应的遗传因素，预计关于治疗反应的表观遗传研究将在不久的将来在文献中积累。在此，我们回顾了迄今为止在确定 RA 中甲氨蝶呤和/或 TNF 抑制剂治疗反应的遗传和表观遗传预测因子方面的进展，并强调了未来研究的重要考虑因素，例如需要改进，最好是生物学的，反映治疗反应的结果衡量标准。
