The influence of HLA phenotypes on the response to parenteral gold in rheumatoid arthritis |
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| Authors: | F. Speerstra P. L. C. M. van Riel P. Reekers L. B. A. van de Putte J. P. Vandenbroucke Collaborating Centres |
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| Affiliation: | Department of Rheumatology, University Hospital St. Radboud, Nijmegen, The Netherlands;Department of Transplantation Serology, University Hospital St. Radboud, Nijmegen, The Netherlands;Department of Epidemiology, Erasmus University, Rotterdam, The Netherlands;Departments of Rheumatology, Elisabeth Hospital and Maria Hospital (H. J. van Beusekom, W. Hissink Muller), Tilburg, and St. Maartens Clinic (D. J. R. A. M. de Rooij, P. J. I. van't Pad Bosch, L. J. J. M. van Haren), Nijmegen, The Netherlands |
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| Abstract: | One hundred and ten patients with rheumatoid arthritis (RA) were studied for a possible influence of HLA phenotypes on the reaction to parenteral gold in the first 6 months of treatment, in terms of both clinical response and toxicity. Frequencies of HLA-B8 and -DR3 were significantly increased in patients who responded excellently to gold treatment as compared with non-responders (p = 0.04 for both antigens). On the other hand, for HLA-DR7 there was a tendency for increased frequency in non-responders versus excellent and moderate responders (p less than 0.03; Pc = n.s.). Drug toxicity was higher in excellent than in non-responders (p less than 0.04), being exceptionally high in male excellent responders (85% versus 33% in females, p less than 0.01), probably due to the increased frequency in B8 and DR3 in the excellent responder group as a whole and in the excellent responder males in particular. We conclude that HLA antigens B8 and DR3 co-determine both toxicity and excellent clinical response to parenteral gold, whereas the presence of DR7 is possibly associated with non-response. In addition, we found sex differences in reaction to parenteral gold, which may be related to an increased frequency of HLA-B8 and -DR3 in male RA patients. |
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