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The association between CYB5A gene rs1790834 polymorphism and clinical improvement after 6 months of leflunomide treatment in women with rheumatoid arthritis

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Abstract

Introduction/objectives

Rheumatoid arthritis (RA) is a disease affecting around 1% of the population in developed countries and can be treated with leflunomide. The higher prevalence of RA among women and numerous previous studies suggested the crucial role of sex hormones. Cytochrome CYB5A regulates the synthesis of androgens. Therefore, the aim of this study was to determine the association between common CYB5A gene polymorphism and the response to leflunomide in women with RA.

Methods

This study included 111 patients. All of them received oral leflunomide monotherapy at a dose of 20 mg daily. Women were genotyped for the presence of CYB5A rs1790834 polymorphism and evaluated monthly for 6 months following the initiation of treatment.

Results

After 6 months of therapy, patients with the GG genotype had higher DAS28 values and less improvement in DAS28 compared to patients with the GA and AA genotypes (p = 0.04). No statistically significant differences were found in relation to other disease activity parameters.

Conclusions

The results of the current study suggest a possible association of the CYB5A rs1790834 polymorphism with some disease activity parameters in RA patients treated with leflunomide during the initial therapy period. However, confirmation of the effect of this polymorphism on the efficacy of leflunomide treatment requires further studies.

Key Points

• Leflunomide is the synthetic disease-modifying anti-rheumatic drug used in the therapy of rheumatoid arthritis.

• CYB5A rs1790834 gene polymorphism may influence the clinical improvement after 6 months of leflunomide treatment in women with rheumatoid arthritis.

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Authors and Affiliations

  1. Department of Physiology, Pomeranian Medical University, 70-111, Szczecin, Poland

    Filip Machaj, Jakub Rosik, Bartosz Szostak & Andrzej Pawlik

  2. Department of Medical Biology, Medical University of Warsaw, 00-575, Warsaw, Poland

    Filip Machaj & Gabriela Olędzka

  3. Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, 70-111, Szczecin, Poland

    Damian Malinowski

  4. Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111, Szczecin, Poland

    Krzysztof Safranow

  5. Division of Cell Biology, Department of Biomedical and Clinical Sciences, Linköping University, 581 85, Linköping, Sweden

    Emilia Wiechec

  6. Faculty of Medicine, Academy of Silesia, 40-555, Katowice, Poland

    Emilia Wiechec

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  1. Filip Machaj
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Correspondence to Andrzej Pawlik.

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The study was approved by the Ethics Committee of Pomeranian Medical University, Szczecin, Poland.

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Machaj, F., Rosik, J., Szostak, B. et al. The association between CYB5A gene rs1790834 polymorphism and clinical improvement after 6 months of leflunomide treatment in women with rheumatoid arthritis. Clin Rheumatol 42, 2477–2483 (2023). https://doi.org/10.1007/s10067-023-06653-1

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  • DOI: https://doi.org/10.1007/s10067-023-06653-1

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