青少年特发性关节炎患者基因多态性与甲氨蝶呤治疗效果的相关性
Associations between gene polymorphisms and treatment outcomes of methotrexate in patients with juvenile idiopathic arthritis.
作者信息
Chen Yuehong, Zou Kun, Sun Jianhong, Yang Yuan, Liu Gang
机构信息
Department of Rheumatology & Immunology, West China Hospital, Sichuan University, Chengdu, PR China.
Department of Medical Record & Statistics, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science & Technology, Chengdu, PR China.
出版信息
Pharmacogenomics. 2018 Apr;19(6):529-538. doi: 10.2217/pgs-2017-0208. Epub 2018 Mar 28.
AIM
Performance of a meta-analysis with respect to the genetic predictors of methotrexate (MTX) treatment outcomes, efficacy and toxicity, in patients with juvenile idiopathic arthritis (JIA).
METHODS
Databases of OVID MEDLINE and OVID EMBASE were searched to collect the studies addressing correlations between gene polymorphisms and efficacy and/or toxicity in MTX-treated JIA patients. Pooled odds ratios (ORs) with 95% CIs were estimated in allelic, recessive and/or dominant models.
RESULTS
With regards to efficacy, the C677T (rs1801133) polymorphism in MTHFR was associated with nonresponse to MTX treatment in a recessive model (OR: 0.40; 95% CI: 0.19-0.84). For associations with toxicity, the MTHFR C677T (rs1801133) polymorphism was associated with presenting overall adverse events in an allelic model (OR: 1.54; 95% CI: 1.07-2.22) and a dominant model (OR: 1.70; 95% CI: 1.08-2.68).
CONCLUSION
C677T (rs1801133) polymorphism in MTHFR predicts nonresponse and/or adverse effects of MTX treatment in JIA patients.
目的
对青少年特发性关节炎（JIA）患者甲氨蝶呤（MTX）治疗结局、疗效及毒性的基因预测因素进行荟萃分析。
方法
检索OVID MEDLINE和OVID EMBASE数据库，以收集关于基因多态性与MTX治疗的JIA患者疗效和/或毒性之间相关性的研究。在等位基因、隐性和/或显性模型中估计合并比值比（OR）及95%置信区间（CI）。
结果
关于疗效，在隐性模型中，亚甲基四氢叶酸还原酶（MTHFR）基因的C677T（rs1801133）多态性与对MTX治疗无反应相关（OR：0.40；95%CI：0.19 - 0.84）。对于毒性相关性，MTHFR C677T（rs1801133）多态性在等位基因模型（OR：1.54；95%CI：1.07 - 2.22）和显性模型（OR：1.70；95%CI：1.08 - 2.68）中与出现总体不良事件相关。
结论
MTHFR基因的C677T（rs1801133）多态性可预测JIA患者对MTX治疗的无反应及/或不良反应。
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