HLA-DRB1 typing in rheumatoid arthritis: Predicting response to specific treatments

James Robert O'Dell, Barbara S. Nepom, Claire Haire, Vivian H. Gersuk, Lakshmi Gaur, Gerald Francis Moore, Walter Drymalski, William Palmer, P. James Eckhoff, Lynell Warren Klassen, Steven Wees, Geoffrey Milton Thiele, Gerald T. Nepom

Research output: Contribution to journalArticlepeer-review

110 Scopus citations


Objective - To determine the predictive value of shared epitope alleles for response to treatment in patients with rheumatoid arthritis. Methods - Patients from our previously published triple DMARD study were tested for the presence of shared epitope alleles (DRB1 *0401,0404/0408, 0405,0101, 1001, and 1402). Patients who were shared epitope positive were then compared with those who were negative to see if there was a differential effect on therapeutic response. Results-Shared epitope positive patients were much more likely to achieve a 50% response if treated with methotrexate-sulphasalazine- hydroxychloroquine compared with methotrexate alone (94% responders versus 32%, p<0.0001). In contrast shared epitope negative patients did equally well regardless of treatment (88% responders for methotrexate-sulphasalazine- hydroxychloroquine versus 83% for methotrexate). Additionally, a trend toward an inverse relation of the gene dose was seen for response to methotrexate treatment (p=0.05). Conclusions - These data suggest that determining shared epitope status may provide clinical information useful in selecting among treatment options.

Original languageEnglish (US)
Pages (from-to)209-213
Number of pages5
JournalAnnals of the rheumatic diseases
Issue number4
StatePublished - 1998

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)


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