Testing pharmacogenetic indices to predict efficacy and toxicity of methotrexate monotherapy in a rheumatoid arthritis patient cohort

✍ Scribed by S. A. Owen; M. Lunt; S. L. Hider; I. N. Bruce; A. Barton; W. Thomson

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 76 KB
• Volume: 62
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.27754

✦ Synopsis

SUDAAN 10 (Research Triangle Institute) and SAS 9.2 (SAS Institute) were used for the statistical analyses of data.

The results from the NIS show that there were 788 cases of PCP among hospitalized patients with RA in the US from 1996 to 2007. Patients were mostly older (73.5% were ages 50-80 years) and female (67.6%). There were no discernable trends in the number of PCP cases over the study period (Figure 1a). Using the California data, we identified 84 cases (2-12 cases/year) of PCP among patients with RA from 1998 to 2007. Patients were primarily older (65.5% were age Ն50 years) and female (75.0%). Adjusted rates of PCP among patients with RA in California ranged from 0.6-4.0 cases/ 100,000 patients/year, with no apparent trend over time (Figure 1B).

We did not identify any trends in cases of PCP among hospitalized patients with RA in the US, and replicated this result in an analysis of rates of PCP among patients with RA in California. These findings indicate that any change in the occurrence of PCP associated with the use of immunosuppressive and biologic agents is not detectable over the background occurrence. Trends may have been obscured if PCP was undiagnosed, if patients with RA who developed PCP were treated as outpatients, or if chemoprophylaxis was routinely used, although there is no evidence that any of these factors changed substantially over the time period examined. Alternatively, use of these medications may not yet be prevalent enough, or this complication may not be frequent enough, to result in increases in rates of PCP at the population level. Our findings are reassuring in that they do not suggest any detectable increase in the frequency of PCP among patients with RA in the US through 2007.