| Autor: |
Janahiraman S; School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia.; Pharmacy Department, Hospital Selayang, Ministry of Health Malaysia, Selayang 68100, Malaysia., Too CL; Immunogenetic Unit, Institute for Medical Research, National Institutes of Health Complex, Ministry of Health Malaysia, Shah Alam 40170, Malaysia., Lee KW; Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 31900, Malaysia., Shahril NS; Medical Department, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya 62250, Malaysia., Leong CO; Centre for Cancer and Stem Cell Research Development and Innovation (IRDI), Institute for Research, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia.; AGTC Genomics, Bukit Jalil, Kuala Lumpur 57000, Malaysia. |
| Abstrakt: |
Rheumatoid arthritis (RA) is a lifelong, debilitating disease which incredibly impacts a patient's quality of life if not treated to the optimal target. The clinical response of tocilizumab, an interleukin-6 (IL-6) inhibitor, is associated with several gene polymorphisms, particularly targeting the IL-6 pathway. This systematic review and meta-analysis seeks to investigate genetic biomarkers that predict the treatment outcome of tocilizumab therapy in RA patients. After evaluating the quality of retrieved records, five studies were chosen to carry out a quantitative synthesis involving 591 participants. We analysed genetic markers of IL-6R single nucleotide polymorphism (SNP)s rs12083537, rs2228145 and rs4329505, FCGR3A, CD69, GALNT18 and FCGR2A. A plausible finding based on meta-analysis revealed that RA patients with homozygous AA genotype for rs12083537 polymorphism of the IL-6R gene demonstrate a better response to TCZ treatment as opposed to homozygous and heterozygous patients with the G allele. Nonetheless, limitations in evaluating the available studies by meta-analysis include a lack of studies with dissimilarities in study design and outcome definitions, small sample sizes with low statistical power and heterogeneity of cohorts, a restricted the number of tested SNPs and small effects for the selected variants. Inconsistent finding remains as a great challenge to forge ahead towards personalised medicine for RA management. |
