Response to methotrexate linked to gender, race, hemoglobin levels in patients with RA

The achievement of low disease activity with methotrexate monotherapy was linked to male gender, white race and higher baseline levels of hemoglobin, according to the results of study on two cohorts.

Researchers studied 83 patients enrolled in the 16-week Rheumatoid Arthritis Investigational Network (RAIN) trial and 297 patients in the Treatment of Early Aggressive Rheumatoid (TEAR) arthritis trial. Most patients in both trials were white and female.

In the RAIN study, the mean change at 16 weeks from baseline in DAS28 was -1.90 and 51% of patients achieved low disease activity. A significant improvement in DAS28 based on the erythrocyte sedimentation rate was associated with male sex, white race and lower baseline neutrophil counts. Investigators found an improvement to meet low disease activity with methotrexate (MTX) monotherapy was associated with male sex, higher hemoglobin levels and lower neutrophil counts at baseline.

Patients in the TEAR study who received methotrexate monotherapy had a mean change of -1.28 from baseline at 12 weeks. Overall, 20% of patients met low disease activity criteria. Male sex, a lower number of tender joints at baseline, higher levels of hemoglobin and lower levels of aspartate transaminase at baseline were associated with a favorable treatment response. Investigators found a nonsignificant trend toward lower DAS28 with baseline neutrophil counts.

“Larger studies with a focus on pharmaco-genetics may be required to identify the RA patients who are ideal candidates for MTX monotherapy,” the researchers wrote. – by Shirley Pulawski

Reference:

Danve A, et al. Paper #2671. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosure: The researchers report no relevant financial disclosures.