Marquez Pete Noelia, Maldonado Montoro María Del Mar, Pérez Ramírez Cristina, Sánchez Martín Almudena, Martínez de la Plata Juan Enrique, Martínez Martínez Fernando, Caliz Caliz Rafael, Daddaoua Abdelali, Ramírez Tortosa María Del Carmen, Jiménez Morales Alberto
Pharmacy Service. Pharmacogenetics Unit, University Hospital Virgen de las Nieves, Avda. Fuerzas Armadas, 2, 18014 Granada, Spain.
Clinical Analysis Service, Hospital Campus de la Salud, Av. de la Investigación, 18016 Granada, Spain.
J Pers Med. 2020 Nov 11;10(4):220. doi: 10.3390/jpm10040220.
Abatacept (ABA) is used as a first-line treatment in patients diagnosed with moderate and severe rheumatoid arthritis (RA). The interindividual response to ABA therapy is very variable in these patients. The objective of our study was therefore to investigate the role of polymorphisms of the , and genes, as well as that of clinical factors of the disease, in the response to ABA in patients with RA. A retrospective cohort study was carried out in 109 patients receiving treatment with ABA and diagnosed with RA. The genetic variables were analyzed using real-time PCR with TaqMan probes. The patients were classified according to the European League Against Rheumatism (EULAR) criteria at 6 and 12 months from start of treatment. The independent variables associated with higher EULAR response were lower duration of previous biologic disease-modifying anti-rheumatic drugs and lower baseline values of the disease activity score 28 after 6 months of ABA treatment; and lower baseline patient's visual analogue scale (PVAS) after 12 months. In addition, a significant association was found between duration of ABA treatment, non-administration of concomitant glucocorticoids and lower baseline values of the number of inflamed joints and erythrocyte sedimentation rate clinical variables, with remission of the disease after 6 months' treatment with ABA. Finally, remission of the disease after 12 months' treatment with ABA was associated with earlier age at start of ABA therapy and lower number of previous biologic therapies (BTs). The allele and the allele were found to be associated with satisfactory EULAR response and low disease activity (LDA) after 12 months' treatment with ABA (; OR = 5.88; CI = 1.48-23.29 and OR = 4.75; CI = 1.35-17.94, respectively, and , OR = 3.48; CI = 1.20-10.09 and OR = 4.68; CI = 1.49-17.94, respectively). In conclusion, patients with RA treated with ABA showed better EULAR response and LDA rate when they had the or polymorphisms; furthermore, this remission rate increased in patients that began ABA treatment earlier, those with a lower number of previous BTs and those with a lower PVAS value.
阿巴西普（ABA）被用作诊断为中度和重度类风湿关节炎（RA）患者的一线治疗药物。在这些患者中，个体对ABA治疗的反应差异很大。因此，我们研究的目的是调查 、 和 基因多态性以及疾病临床因素在RA患者对ABA反应中的作用。对109例接受ABA治疗并诊断为RA的患者进行了一项回顾性队列研究。使用带有TaqMan探针的实时PCR分析基因变量。根据欧洲抗风湿病联盟（EULAR）标准，在治疗开始后的6个月和12个月对患者进行分类。与较高EULAR反应相关的独立变量是先前生物性改善病情抗风湿药物的使用时间较短以及ABA治疗6个月后疾病活动评分28的基线值较低；以及12个月后患者视觉模拟量表（PVAS）的基线值较低。此外，发现ABA治疗时间、未同时使用糖皮质激素以及炎症关节数量和红细胞沉降率临床变量的较低基线值与ABA治疗6个月后疾病缓解之间存在显著关联。最后，ABA治疗12个月后疾病缓解与ABA治疗开始时年龄较小以及先前生物治疗（BTs）次数较少有关。发现 等位基因和 等位基因与ABA治疗12个月后令人满意的EULAR反应和低疾病活动度（LDA）相关（ ，OR = 5.88；CI = 1.48 - 23.29和OR = 4.75；CI = 1.35 - 17.94，以及 ，OR = 3.48；CI = 1.20 - 10.09和OR = 4.68；CI = 1.49 - 17.94）。总之，接受ABA治疗的RA患者在具有 或 多态性时表现出更好的EULAR反应和LDA率；此外，在更早开始ABA治疗、先前BTs次数较少以及PVAS值较低的患者中，这种缓解率会增加。
