Table 3

Summary of nongenetic biomarkers of response to MTX and other DMARDs.

Factors

Predictors of response?k

Comments


RF

No

Some results confounded by its poor prognostic role; however, most evidence is clear in that it does not influence treatment response

ACPA

Not likely

More data needed but does not seem to predict response; associated with worse outcomes in some studies but may reflect more severe disease; interesting reports in UA, pending confirmation

Anti-MCV

Unknown

Suggested to relate to more severe disease; not yet addressed in terms of response to treatment

Creatinine clearance

No

Few studies analyzed this factor, no association with MTX response in a meta-analysis

Hb levels

Uncertain

Anecdotal reports of association with better response; needs confirmation and its role should be clarified in future studies

Cytokines

Uncertain

Small/pilot studies suggesting association with response; potential promising role of baseline TNF levels, TNFID50 and IL-1ra/IL-1β ratio

Others

Uncertain

Other interesting factors analyzed in small studies and not further confirmed include MMP-3, urinary 7-OH-MTX and IgG hypogalactosylation


Conclusions and comments are based on the findings reported and discussed in the text. ACPA, anti-citrullinated protein antibodies; anti-MCV, anti-modified citrullinated vimentin antibodies; DMARDs, disease modifying anti-rheumatic drugs; Hb, hemoglobin; IgG, immunoglobulin G; IL-1ra, interleukin-1 receptor antagonist; IL-1β, interleukin-1β; MMP-3, matrix metalloproteinase-3; MTX, methotrexate; RF, rheumatoid factor; TNF, tumor necrosis factor; TNFID50, dose required to suppress by 50% the production of tumor necrosis factor; UA, undifferentiated arthritis; 7-OH-MTX, 7-hydroxy-methotrexate.

Romão et al. BMC Medicine 2013 11:17   doi:10.1186/1741-7015-11-17

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