title: Association between tumor necrosis factor-α (TNF-α) promoter -308 G/A and response to TNF-α blockers in rheumatoid arthritis: a meta-analysis.
abstract: OBJECTIVE
  Tumor necrosis factor (TNF)-α promoter -308G/A polymorphism has been shown to be associated with high TNF-α production and poor response to anti-TNF-α treatment. However, not all patients show a good response to TNF-α antagonists, so this association remains controversial. This study was designed to investigate whether TNF-α promoter -308 G/A polymorphism is associated with responsiveness to anti-TNF therapy in rheumatoid arthritis (RA) patients. The 28-joint count Disease Activity Score (DAS) 28 or the American College of Rheumatology (ACR) improvement criteria 20 were used to measure patient response.
  
  
  METHODS
  A meta-analysis was performed. Pooled ORs and 95 % CIs were calculated by both dominant and recessive genetic models.
  
  
  RESULTS
  Fifteen studies with a total of 2127 patients were included in this meta-analysis. The results showed that patients with the G allele responded better to the treatment (OR = 1.87, 95 % CI 1.26-2.79). A subanalysis showed similar results.
  
  
  CONCLUSIONS
  Based on the results of this meta-analysis, RA patients with the TNF-α promoter -308 G allele respond better to TNF-α antagonist treatment, suggesting that this allele plays a major role in anti-TNF-alpha treatment response.
authors: Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
authors: Zhen
authors: Z
authors: Zeng
authors: Zhenhua
authors: Z
authors: Duan
authors: Tianchen
authors: T
authors: Zhang
authors: Sheng
authors: S
authors: Wang
authors: Guixing
authors: G
authors: Li
authors: Jing
authors: J
authors: Gao
authors: Dongqing
authors: D
authors: Ye
authors: Shengqian
authors: S
authors: Xu
authors: Jianhua
authors: J
authors: Xu
authors: Li
authors: L
authors: Zhang
authors: Faming
authors: F
authors: Pan
mesh_terms: D000483:Alleles; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000235:genetics*; D006801:Humans; D010597:Pharmacogenetics; D011401:Promoter Regions, Genetic; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000235:genetics*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha