title: A longitudinal genome-wide association study of anti-tumor necrosis factor response among Japanese patients with rheumatoid arthritis.
abstract: BACKGROUND
  Studies of Caucasian patients with rheumatoid arthritis (RA) to identify genetic biomarkers of anti-tumor necrosis factor (TNF) response have used response at a single time point as the phenotype with which single nucleotide polymorphism (SNP) associations have been tested. The findings have been inconsistent across studies. Among Japanese patients, only a few SNPs have been investigated. We report here the first genome-wide association study (GWAS) to identify genetic biomarkers of anti-TNF response among Japanese RA patients, using response at 2 time-points for a more reliable clinical phenotype over time.
  
  
  METHODS
  Disease Activity Scores based on 28 joint counts (DAS28) were assessed at baseline (before initial therapy), and after 3 and 6 months in 487 Japanese RA patients starting anti-TNF therapy for the first time or switching to a new anti-TNF agent. A genome-wide panel of SNPs was genotyped and additional SNPs were imputed. Using change in DAS28 scores from baseline at both 3 (ΔDAS-3) and 6 months (ΔDAS-6) as the response phenotype, a longitudinal genome-wide association analysis was conducted using generalized estimating equations (GEE) models, adjusting for baseline DAS28, treatment duration, type of anti-TNF agent and concomitant methotrexate. Cross-sectional analyses were performed using multivariate linear regression models, with response from a single time point (ΔDAS-3 or ΔDAS-6) as phenotype; all other variables were the same as in the GEE models.
  
  
  RESULTS
  In the GEE models, borderline significant association was observed at 3 chromosomal regions (6q15: rs284515, p = 6.6x10(-7); 6q27: rs75908454, p = 6.3x10(-7) and 10q25.3: rs1679568, p = 8.1x10(-7)), extending to numerous SNPs in linkage disequilibrium (LD) across each region. Potential candidate genes in these regions include MAP3K7, BACH2 (6q15), GFRA1 (10q25.3), and WDR27 (6q27). The association at GFRA1 replicates a previous finding from a Caucasian dataset. In the cross-sectional analyses, ΔDAS-6 was significantly associated with the 6q15 locus (rs284511, p = 2.5x10(-8)). No other significant or borderline significant associations were identified.
  
  
  CONCLUSIONS
  Three genomic regions demonstrated significant or borderline significant associations with anti-TNF response in our dataset of Japanese RA patients, including a locus previously associated among Caucasians. Using repeated measures of response as phenotype enhanced the power to detect these associations.
authors.affiliation: Division of Rheumatology and Clinical Immunology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Honne
authors.affiliation: 23andme, Mountain View, CA, USA.
authors.forename: Ingileif
authors.initials: I
authors.lastname: Hallgrímsdóttir
authors.affiliation: Research Unit of Gynecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.|Department of Obstertics & Gynecology, Odense University Hospital, Odense, Denmark.
authors.forename: Chunsen
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Sebro
authors.affiliation: School of Public Health, University of California, Berkeley, CA, 94720, USA.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Jewell
authors.affiliation: Inoue Hospital, Takasaki, Gunma, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Sakurai
authors.affiliation: Division of Rheumatology and Clinical Immunology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iwamoto
authors.affiliation: Division of Rheumatology and Clinical Immunology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Minota
authors.affiliation: Center for Genetics, Children's Hospital Oakland Research Institute, Oakland, CA, 94609, USA. djawaheer@chori.org.
authors.forename: Damini
authors.initials: D
authors.lastname: Jawaheer
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics*; D044466:Asian People / Q000235:genetics*; D003430:Cross-Sectional Studies; D000068800:Etanercept / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D055106:Genome-Wide Association Study / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011446:Prospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept