Responses of patients with juvenile idiopathic arthritis to methotrexate: a genomic outlook

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Davide Selvestrel1, Marianna Lucafò2, Letizia Pugnetti3

  • 1Department of Life Sciences, University of Trieste, Trieste, Italy.

Expert Review of Clinical Immunology
|August 16, 2021
PubMed

Insights

Genetics and epigenetics influence treatment response in juvenile idiopathic arthritis (JIA). Identifying biomarkers for methotrexate (MTX) efficacy in JIA patients is crucial for personalized medicine.

Area of Science:

  • Rheumatology
  • Pharmacogenetics
  • Epigenetics

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic pediatric rheumatic disease with no cure.
  • Methotrexate (MTX) is a common JIA treatment, but patient response varies significantly.
  • Genetic and epigenetic factors may explain individual differences in MTX response.

Purpose of the Study:

  • To review pharmacogenetic and pharmacoepigenetic studies on MTX response in JIA.
  • To discuss biomarkers for MTX treatment in JIA patients.
  • To highlight the need for further research into predictive genetic and epigenetic markers.

Main Methods:

  • Literature review of pharmacogenetic and pharmacoepigenetic studies.
  • Inclusion of studies on adult rheumatoid arthritis due to limited JIA epigenetic data.
  • Discussion of blood and urine biomarkers relevant to MTX treatment.

Main Results:

  • No specific genetic marker currently predicts MTX efficacy or adverse events in JIA.
  • Epigenetic studies in JIA are limited but show promise.
  • Biomarker research is ongoing.

Conclusions:

  • Pharmacogenetics and pharmacoepigenetics are key to understanding MTX variability in JIA.
  • Further research is needed to identify reliable genetic and epigenetic biomarkers.
  • Implementation of biomarkers in clinical practice could personalize JIA treatment.
Abstract

Keywords:
Methotrexatejuvenile idiopathic arthritispharmacoepigeneticspharmacogeneticsserum biomarkerstherapy personalization

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