HLA-DR1-positive patients suffering from rheumatoid arthritis are at high risk for developing mucocutaneous side effects upon gold therapy.
Population studies suggest an association between RA and, depending on the ethnic background, HLA-DR1 and/or -DR4. One standard regimen for the treatment of RA is the use of gold compounds like SATM to arrest progression of the disease. In the present study, the immunogenetic background of RA patients developing side effects upon SATM treatment was determined. A total of 53 patients under SATM therapy were tested for their HLA-DRB and -DQ alleles by DNA typing; a significantly higher frequency of HLA-DR1 (p < 0.004, uncorrected) was observed in patients presenting with mucocutaneous side effects (MCT) when compared with patients without MCT. The RR was 6.85. Thus, HLA-DR1 seems to be a marker for the susceptibility of gold adverse reactions.
Pickl
W F
WF
Clinical Department for Blood Group Serology, Austria.
Fischer
G F
GF
Faé
I
I
Kolarz
G
G
Scherak
O
O
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D006052:Gold Sodium Thiomalate / Q000009:adverse effects*; D006683:HLA-DQ Antigens / Q000502:physiology; D015798:HLA-DR1 Antigen / Q000235:genetics / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects*; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D012871:Skin Diseases / Q000139:chemically induced* / Q000235:genetics
D006683:HLA-DQ Antigens; D015798:HLA-DR1 Antigen; D006052:Gold Sodium Thiomalate