Factors predicting the response to low-dose methotrexate therapy in patients with rheumatoid arthritis: a better response in male patients

Kameda, Hideto; Amano, Koichi; Sekiguchi, N.; Takei, Hiroyuki; Ogawa, Hidenori; Nagasawa, Hayato; Takeuchi, Tsutomu

doi:10.1007/s10165-004-0340-3

Cited by 12 publications

(16 citation statements)

References 6 publications

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“…4 After 1 year of treatment, Buc treatment had not been discontinued in 69.2% of the patients and MTX treatment had not been discontinued in 83.1% of the patients; after 3 years, the continuation rates were 31.1% and 69.1%, respectively (Fig. 7).…”

Section: Continuation Rates For Buc Treatmentmentioning

confidence: 90%

“…The effects of Buc on TJC, SJC, and CRP, as well as DAS28-3(crp), and the Buc continuation rates were compared with previously reported results for MTX. 4 Bucillamine treatment was regarded as insufficient when prednisolone (PSL) or another DMARD was added or when the dosage of Buc was increased during the observation period. All adverse events that occurred while receiving Buc were also evaluated.…”

Section: Methodsmentioning

confidence: 99%

“…4 Among them, 26 patients initially received Buc and subsequently were additionally given MTX because the Buc treatment was insufficient. One hundred eleven patients (31.8%) had been receiving PSL treatment (mean dose, 6.3 mg/day) when Buc administration was commenced.…”

Section: Efficacy Of Buc and Mtx Treatmentsmentioning

confidence: 99%

“…The clinical data obtained from patients at the beginning of the first Buc therapy were compared with the clinical data obtained from patients who had just started receiving MTX for the first time. 4 The demographic and clinical features of the patients who received Buc are shown in Table 1. When compared to the MTX study, significant differences were seen in disease duration (8.5 ± 8.7 years for MTX-treated patients; P < 0.001), stage (I: 11.0%, II: 37.1%, III: 12.4%, IV: 39.5% for MTX-treated patients; P < 0.001), TJC (6.7 ± 5.9 for MTX-treated patients; P < 0.001), SJC (7.4 ± 5.8 for MTX-treated patients; P < 0.05), and CRP (4.9 ± 4.2 for MTX-treated patients; P < 0.001) when evaluated using t-tests, suggesting that MTX tended to be given to those with longstanding and highly active RA, while Buc treatment was started earlier, as indicated by the fact that 25.9% of the patients were radiographically classified as Stage I.…”

Section: Efficacy Of Buc and Mtx Treatmentsmentioning

confidence: 99%

“…4 First, the Japanese Ministry of Health, Labour and Welfare has approved MTX only as a second-line therapy for RA patients who have failed to respond to at least one other DMARD. Second, the maximum approved weekly dosage of MTX is 8 mg.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of bucillamine, a d-penicillamine analogue, in patients with active rheumatoid arthritis

et al. 2006

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Japanese rheumatologists consider bucillamine (Buc) to be a useful disease-modifying antirheumatic drug (DMARD) and often give Buc to patients with rheumatoid arthritis (RA) prior to administering methotrexate (MTX). However, no large studies on the efficacy and safety of Buc in RA patients have been published in English to date. We therefore investigated the clinical course of RA patients treated with Buc and compared the results with those for patients treated with MTX to evaluate and confirm the place of Buc in therapeutic strategies for RA in Japan. Our results suggested that Buc should be given to patients with moderately active RA either before or after the administration of MTX because its efficacy can be judged within 3 months and because serious adverse events are rare. Issues like the ability of Buc to prevent joint destruction and its efficacy and safety when combined with agents like etanercept require future study.

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Section: Continuation Rates For Buc Treatmentmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Efficacy Of Buc and Mtx Treatmentsmentioning

confidence: 99%

Section: Efficacy Of Buc and Mtx Treatmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of bucillamine, a d-penicillamine analogue, in patients with active rheumatoid arthritis

et al. 2006

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Sex Differences in mRNA Expression of Reduced Folate Carrier‐1, Folypolyformyl Glutamate Synthase, and γ‐Glutamyl Hydrolase in a Healthy Japanese Population

Hashiguchi

Tanaka

Shimizu

et al. 2016

The Journal of Clinical Pharma

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Sex differences in the prevalence of autoimmune diseases such as rheumatoid arthritis (RA) are well known, but little is known about those differences in relation to therapeutic response. Reduced folate carrier-1 (RFC-1), folypolyformyl glutamate synthase (FPGS), and γ-glutamyl hydrolase (GGH) are important transporters and enzymes that convert methotrexate (MTX) in the body. This study investigated the sex differences in mRNA expression of RFC-1, FPGS, and GGH in 190 unrelated healthy Japanese people. The genotypes and mRNA expression were determined using the real-time PCR method. Significant differences between men and women were observed in RFC-1, FPGS, and GGH mRNA expression. The mRNA expression of FPGS and GGH was greater in women than that in men, but the expression of RFC-1 was less in the former than the latter. In stratified analysis by genotype, significant differences in sex-specific mRNA expression were observed in G/G of FPGS, C/C of GGH 452, and C/C of GGH -401. All showed greater mRNA expression in women than in men. In the 5 single-nucleotide polymorphisms RFC-1 80G>A, RFC-1 -43T>C, FPGS 1994G>A, GGH 452C>T, and GGH -401C>T examined, the FPGS 1994 G/G (1.46-fold), GGH 452 C/C (2.16-fold), and GGH -401 C/C (2.68-fold) genotypes showed significantly higher mRNA expression in women than in men. Healthy Japanese adults in this study showed sex-specific differences in mRNA expression that differed among RFC-1, FPGS, and GGH. Therefore, the relationship between genetic polymorphisms and mRNA expression including sex differences might contribute to the variation in the efficacy/toxicity of MTX in patients with RA.

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Development and validation of handy rheumatoid activity score with 38 joints (HRAS38) in rheumatoid arthritis patients receiving infliximab

et al. 2006

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The parameters involved in the Disease Activity Score of 28 joints (DAS28) are not mutually independent, and the evaluation excludes ankle and foot joints. We developed a new quantitative and comprehensive assessment of the activity of rheumatoid arthritis (RA), called the handy rheumatoid activity score, with 38 joints (HRAS38), to overcome these disadvantages of DAS28. Forty-six RA patients who recently completed a 1-year infliximab therapy were evaluated for DAS28 (C-reactive protein; CRP) and HRAS38 at 0, 2, 6, 14, 22, 30, 38, 46, and 54 weeks. The 38-joint evaluation in HRAS38 includes 28 joints of DAS28 except for the shoulder joints, with the addition of ankle and metatarsophalangeal joints. The extent of joint swelling was rated on a scale of 0-3. The HRAS38 score is the cumulative sum of three parameters including: (1) a global assessment of disease activity [visual analog scale (VAS) 0-100 mm] by the patient, (2) swollen joint score based on a 38-joint assessment by a physician (0-114), and (3) serum concentration of CRP (mg/l). Scatter plots of HRAS38 and DAS28(CRP), and subsequent linear regression analysis demonstrated a statistically significant correlation between methodologies (r = 0.846, P < 0.0001). Infliximab treatment resulted in a statistically significant (P < 0.001) decrease in the mean HRAS38 score from 130.5 to 56.5 within 2 weeks of treatment and at 52 weeks of therapy scores were still reduced at 52.5. The mean DAS28(CRP) was also significantly (P < 0.001) reduced from a baseline value of 5.8 to 3.7 after 2 weeks treatment with a final value of 3.2 after 52 weeks of therapy. Infliximab reduced the progression of joint destruction by 85%, for terms before infliximab as determined by radiographic analyses. The degree of progression appeared to be associated with the mean HRAS38, although this observation was not shown to be statistically significant by regression analysis (r = 0.307). The HRAS38 score comprises minimal and independently acquired parameters and is an effective and comprehensive measure of disease activity in RA patients.

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Factors predicting the response to low-dose methotrexate therapy in patients with rheumatoid arthritis: a better response in male patients

Cited by 12 publications

References 6 publications

Efficacy and safety of bucillamine, a d-penicillamine analogue, in patients with active rheumatoid arthritis

Efficacy and safety of bucillamine, a d-penicillamine analogue, in patients with active rheumatoid arthritis

Sex Differences in mRNA Expression of Reduced Folate Carrier‐1, Folypolyformyl Glutamate Synthase, and γ‐Glutamyl Hydrolase in a Healthy Japanese Population

Development and validation of handy rheumatoid activity score with 38 joints (HRAS38) in rheumatoid arthritis patients receiving infliximab

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