title: The role of Fcγ receptor polymorphisms in the response to anti–tumor necrosis factor therapy in psoriasis A pharmacogenetic study.
abstract: OBJECTIVE
  Variability in genes encoding proteins involved in the immunological pathways of biological therapy may account for the differences observed in outcomes of anti–tumor necrosis factor (TNF) treatment of psoriasis.
  
  
  OBJECTIVE
  To assess the role of 2 Fcγ receptor (FcγR) polymorphisms in the response to anti-TNF therapy in psoriasis.
  
  
  METHODS
  Retrospective series of patients with psoriasis who received anti-TNF therapy(infliximab, adalimumab, or etanercept) from January 1, 2007, through December 31, 2010. Patients were followed up for 12 weeks.
  
  
  METHODS
  Two psoriasis referral centers.
  
  
  METHODS
  Seventy treatment-naive patients with moderate to severe psoriasis who received anti-TNF agents.
  
  
  METHODS
  Patients underwent FcγRIIA-H131R and FcγRIIIA-V158F polymorphism genotyping.
  
  
  METHODS
  The Psoriasis Area and Severity Index and the body surface area were assessed at baseline and at treatment weeks 6 to 8 and 12. The polymorphism genotypes were correlated with the treatment outcomes.
  
  
  RESULTS
  Bivariate analysis showed a nonsignificant association between FcγR low-affinity genotypes and greater improvement in the Psoriasis Area and Severity Index and body surface area at the end of treatment. Conversely, patients harboring high-affinity alleles presented a greater reduction in body surface area at the intermediate point, which remained independent in the multivariate analysis. We also detected an additive effect of both polymorphisms in the multivariate analysis. High-affinity alleles may contribute to a quicker response owing to a more efficient removal of relevant cells expressing TNF.
  
  
  CONCLUSIONS
  Preliminary results of this pilot study on the pharmacogenetics of FcγR and biological therapy in psoriasis suggest a role with clinical implications for FcγRIIA-H131R and FcγRIIIA-V158F polymorphisms in the outcome of anti-TNF treatment of psoriasis. These results might help dermatologists in guiding therapeutic decisions, especially in very severe cases where a quick response is needed.
authors.forename: Marc
authors.initials: M
authors.lastname: Julià
authors.forename: Antonio
authors.initials: A
authors.lastname: Guilabert
authors.forename: Francisco
authors.initials: F
authors.lastname: Lozano
authors.forename: Belén
authors.initials: B
authors.lastname: Suarez-Casasús
authors.forename: Nemesio
authors.initials: N
authors.lastname: Moreno
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Carrascosa
authors.forename: Carlos
authors.initials: C
authors.lastname: Ferrándiz
authors.forename: Edurne
authors.initials: E
authors.lastname: Pedrosa
authors.forename: Mercè
authors.initials: M
authors.lastname: Alsina-Gibert
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Mascaró
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007074:Immunoglobulin G / Q000494:pharmacology / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010597:Pharmacogenetics; D020641:Polymorphism, Single Nucleotide; D011565:Psoriasis / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D017452:Receptors, IgG / Q000235:genetics*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; D007074:Immunoglobulin G; D017452:Receptors, IgG; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept