BackgroundTocilizumab (TCZ) is a humanised monoclonal antibody inhibitor of interleukin-6 receptor, indicated in combination with methotrexate in the treatment of rheumatoid arthritis (RA) in patients with inadequate response or intolerance to prior therapy.PurposeThe aim of our study was to explore the potential role of KCNMB1 genetic polymorphisms as a predictor of tocilizumab efficacy in RA patients.Material and methodsThe KCNMB1 (A >G) (rs703505) genetic variant was genotyped using predesigned TaqMan genotyping assay technology and analysed on a ViiA7 real time PCR system. Clinical response was evaluated at 24 weeks with the use of the 28 joint disease activity score criteria (DAS28). Clinical response was evaluated at 14 weeks using DAS28 and good response and remission were classified according to EULAR criteria. EULAR good response was defined as a change in DAS28 >1.2 and DAS28 ≤3.2. EULAR remission was defined as DAS28 ≤2.6 at 14 weeks. Statistical analysis was performed using SPSS v.20.ResultsClinical data for 140 tocilizumab treated patients were obtained. Patients were aged (mean±SD) 53.25 ± 12.42 years; 79% were female. Mean DAS28 at baseline was 5.71 ± 1.13. KCNMB1-GG genetic polymorphism was associated with EULAR good response (GG vs no GG p = 0.26, OR=0.37, 95% CI 0.14 to 0.93) and with EULAR remission (p = 0.01, OR=0.29, 95% CI 0.09 to 0.87).ConclusionOur results confirm that KCNMB1 (A >G) rs703505 polymorphisms could be useful as a genetic marker of tocilizumab efficacy in RA patients. More studies are necessary to confirm these results.No conflict of interest.
BackgroundCD69 receptor is a C lectin transmembrane protein expressed by T cells, natural killer (NK) cells and active B cells. This receptor is involved in the production and regulation of T cells, B cells and NK cells, and these are involved in interleukin 6 (IL-6) production. IL-6 is a multifunctional glycoprotein involved in the immune response, inflammation and bone metabolism; IL-6 makes significant contributions to autoimmune and inflammatory diseases such as rheumatoid arthritis (RA). Tocilizumab is a humanised monoclonal antibody inhibitor of IL-6 receptor, indicated in combination with methotrexate in the treatment of RA in patients with inadequate response or intolerance to prior therapies.PurposeThe aim of this study was evaluate the role of the CD69 A>G (rs11052877) genetic polymorphism on the response to tocilizumab in RA patients.Material and methodsThe CD69 A>G (rs11052877) genetic polymorphism was genotyped using predesigned TaqMan genotyping assay technology and analysed on a ViiA7 real time PCR system. Clinical response was evaluated at 3, 6, 9 and 12 months after the first infusion of the drug, using the 28 joint disease activity score criteria (DAS28), and good responders were classified according to EULAR criteria. EULAR good response was defined as a change in DAS28 >1.2 and DAS28 ≤3.2. Statistical analysis was performed using SPSS V.20.ResultsClinical data from 140 tocilizumab treated patients were obtained. The patients were aged (mean±SD) 53.25±12.42 years and 79% were women. Even though we found a greater proportion of good responders among CD69 GG carriers than among A/G or A/A carriers at 3 months (60% vs 43.27%), 6 months (72.73% vs 59.17%), 9 months (76.19% vs 65.66%) and 12 months (90% vs 73.95%), these results were not statistically significant (p=0.17, p=0.22, p=0.34 and p=0.09)ConclusionThese results show that the CD69 A>G (rs11052877) genetic polymorphism by itself is not useful as a predictor of tocilizumab response in RA patients but its influence should be studied further.No conflict of interest
BackgroundThere has been an increase in the number of chronic conditions concomitantly present in HIV-infected individuals and correspondingly, in comedication. Beliefs play a crucial role in medicines adherence.PurposeTo investigate the relationship between beliefs (necessity and concerns) of HIV-infected patients about comedication and their adherence.Material and methodsWe conducted a cross-sectional study between May–July 2014, that included HIV-infected patients treated with antiretroviral treatment (ART) and ≥1 additional drugs for other chronic diseases.The variables analysed in the study were demographics (sex, age), mode of transmission, CD4+, HIV plasma viral load, beliefs about comedication and adherence to treatment for chronic conditions.The Beliefs about Medicines Questionnaires (BMQ) was used to assess patients’ beliefs about drugs for additional diseases. The BMQ-Specific has two scales (necessity and concern) with five questions each that uses a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = uncertain, 4 = agree, 5 = strongly agree). A total score per scale was calculated. Self-reported comedication adherence was measured using the 4-item Morisky Medication Adherence Scale (MMAS). MMAS scores were dichotomised into adherent/non-adherent.Internal consistency within BMQ scales was measured with Cronbach’s α and their association with adherence was assessed with t-Student tests, using SPSS 20.0.ResultsWe included 126 patients (80.4% male, mean age 50.4 ± 8.3). Injected drug use was the main mode of transmission. 43.7% of patients presented CD4+ ≤ 500 cells/mm3 and 25.4%, detectable viral load. The mean number of additional medicines was 2.9 ± 2.0.The percentage of non-adherent patients was 54.0%. Belief in necessity was positively related to self-reported adherence. No relationship between adherence and concern was found. Internal consistency for BMQ-Specific was high (Cronbach’s alfa = 0.724) which indicates high intercorrelation between items.Abstract CP-025 Table 1BMQ-Specific scale> Cronbach´s alfa Non-Adherent (Mean±SD)Adherent (Mean±SD) p-value Necessity0.79417.3 ± 5.618.8 ± 4.40.188Concern 0.785 14.6 ± 5.7 12.1 ± 6.1 0.019ConclusionGreater conviction that comedication is necessary was associated with higher self-reported adherence in HIV infected-patients, suggesting that it could be important to focus on the necessity of this treatment to improve adherence.References And/or AcknowledgementsPlos One 2013;8(12):e80633No conflict of interest.
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