Clinical markers combined with HMGB1 polymorphisms to predict efficacy of conventional DMARDs in rheumatoid arthritis patients.

The efficacy of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) for rheumatoid arthritis (RA) patients was limited. However, there were no predictive markers for poor csDMARDs outcome. Clinical information of RA patients was collected and the high-mobility group box 1 (HMGB1) polymorphisms (rs4145277, rs2249825, rs1412125 and rs1045411) were examined. Among the 252 patients, 31.0% had no response of csDMARDs. Anti-citrullinated protein antibody (ACPA)-positive, C-reactive protein (CRP) and Disease Activity Score (DAS) 28- erythrocyte sedimentation rate (ESR) were the associated factors, which (DAC:DAS 28 > 4.7 and ACPA-positive and CRP > 7.1 mg/L) was used to predict poor csDMARDs outcome, the sensitivity and specificity was 87.2% and 60.9%, respectively. Among those DAC patients, the refractory RA rate in the rs2249825 GG genotype patients was 83.3%, the specificity was 98.5%. The clinical markers (DAC) and rs2249825 GG genotype can be used to predict poor csDMARDs outcome.