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Methotrexate pharmacogenetics in the treatment of rheumatoid arthritis
Biljana Jekic1, Nela Maksimovic1, Tatjana Damnjanovic1
1Institute of Human Genetics, Faculty of Medicine, University of Belgrade,11000 Belgrade, Serbia.
Abstract:
For many decades, methotrexate (MXT) has remained the drug of choice in the treatment of rheumatoid arthritis (RA). Unfortunately, a considerable number of patients do not achieve an appropriate therapeutic response. Pharmacogenetics studies do not give usable results regarding differences in MTX response among RA patients. The mechanism of MTX action in RA is not completely understood. We present and discuss data regarding the molecular basis of folate and adenosine pathways, the most obvious MTX targets, to explain possible causes of therapy failure. The molecular basis of the disease could also have an impact on therapy outcomes and in this review we explore this. Finally, we make a short review of available pharmacogenetics study results.
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