Measurement of erythrocyte methotrexate polyglutamate levels: Ready for clinical use in rheumatoid arthritis?

被引：24
作者：
Danila M.I. [1 ]
Hughes L.B. [1 ]
Brown E.E. [1 ]
Morgan S.L. [1 ]
Baggott J.E. [1 ]
Arnett D.K. [1 ]
Bridges Jr. S.L. [1 ]
机构：
[1] Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL 35294-2182
来源：
Current Rheumatology Reports | 2010年 / 12卷 / 5期
基金：
美国国家卫生研究院;
关键词：
Methotrexate; Polyglutamates; Rheumatoid arthritis;
D O I：
10.1007/s11926-010-0120-3
中图分类号：
学科分类号：
摘要：
Methotrexate (MTX) is one of the most commonly prescribed and most effective drugs for the treatment of rheumatoid arthritis (RA). Given the partial response of many patients and the side effect profile of the drug, there is considerable interest in identifying biomarkers to guide MTX therapy in RA. Upon entering cells, MTX is polyglutamated. Measuring MTX polyglutamate (MTX PG) levels in circulating red blood cells has been proposed as an objective measure to help optimize MTX therapy in RA. Data are conflicting with regard to the clinical utility of MTX PG measurements as a predictor of the efficacy or toxicity of lowdose MTX effects in RA. Should large, randomized clinical trials of this assay show consistent, reproducible, long-term correlations between MTX PG levels and efficacy or toxicity, this test could become a prominent tool for clinicians to optimize the use of MTX in treating RA. © Springer Science+Business Media, LLC 2010.
引用
收藏
页码：342 / 347
页数：5
相关论文
共 29 条
  • [1] Weinblatt M.E., Coblyn J.S., Fox D.A., Et al., Efficacy of low-dose methotrexate in rheumatoid arthritis, N Engl J Med, 312, pp. 818-822, (1985)
  • [2] Kremer J.M., Lee J.K., The safety and efficacy of the use of methotrexate in long-term therapy for rheumatoid arthritis, Arthritis Rheum, 29, pp. 822-831, (1986)
  • [3] Weinblatt M.E., Kaplan H., Germain B.F., Et al., Methotrexate in rheumatoid arthritis A five-year prospective multicenter study, Arthritis Rheum, 37, pp. 1492-1498, (1994)
  • [4] Finckh A., Bansback N., Marra C.A., Et al., Treatment of very early rheumatoid arthritis with symptomatic therapy, disease-modifying antirheumatic drugs, or biologic agents: A cost-effectiveness analysis, Ann Intern Med, 151, pp. 612-621, (2009)
  • [5] Emery P., Breedveld F., Van Der Heijde D., Et al., Two-year clinical and radiographic results with combination etanerceptmethotrexate therapy versus monotherapy in early rheumatoid arthritis: A two-year, double-blind, randomized study, Arthritis Rheum, 62, pp. 674-682, (2010)
  • [6] Schoels M., Knevel R., Aletaha D., Et al., Evidence for treating rheumatoid arthritis to target: Results of a systematic literature search, Ann Rheum Dis, 69, pp. 638-643, (2010)
  • [7] Walker A.M., Funch D., Dreyer N.A., Et al., Determinants of serious liver disease among patients receiving low-dose methotrexate for rheumatoid arthritis, Arthritis Rheum, 36, pp. 329-335, (1993)
  • [8] Salliot C., Van Der Heijde D., Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: A systematic literature research, Ann Rheum Dis, 68, pp. 1100-1104, (2009)
  • [9] Dervieux T., Greenstein N., Kremer J., Pharmacogenomic and metabolic biomarkers in the folate pathway and their association with methotrexate effects during dosage escalation in rheumatoid arthritis, Arthritis Rheum, 54, pp. 3095-3103, (2006)
  • [10] Tishler M., Caspi D., Graff E., Et al., Synovial and serum levels of methotrexate during methotrexate therapy of rheumatoid arthritis, Br J Rheumatol, 28, pp. 422-423, (1989)
123