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Monday, March 10, 2014
  Clinical Accuracy Spoken Here  

RA: Susceptibility Factors

HLA-DRB1, (a genetic factor that is associated with all populations studied) and PTPN22 are the main genetic factors associated with the development of RA. The HLA-DRB1 shared epitope is:

  • Associated with disease severity
  • Predictive of response to aggressive therapies

Substantial differences in genetic RA susceptibility factors have been found between European and Asian populations:

  • PTPN22 polymorphisms have been identified in European but are rarely found in Asian populations
  • Conversely, polymorphisms of PAD14 have been more consistently found in Asian than in European populations

[Reference: RA, Module A, Prevalence and Pathophysiology]
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  Excellence in Case Mgmt  

RA: Gender Factors

As previously stated, women are afflicted with RA two to four times as often as men and there has been some evidence that the predisposition is hormonally-related. However, female dominance remains largely unexplained. Importantly, these relationships determine the risk for the disease, not the severity of the disease.

A number of studies have documented clinical observations about the relationships between female hormonal and reproductive factors and possible affects on RA risk. Among studies the results are at times conflicting.

[Reference: RA, Module A, Prevalence and Pathophysiology]
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  Improving Patient Care...  

RA: Genetic Factors

Genetic factors are relevant to the treatment of RA because the activity of enzymes in the metabolism of drugs is in part genetically determined. This applies to methotrexate and azathioprine including:

  • Methylenetetrahydrofolate reductase
  • Thiopurine methyltransferase
Pharmaco-genetics is a rapidly advancing area of research that holds the promise that therapies will soon be tailored to individual patients' genetic profiles.

[Reference: RA, Module A, Prevalence and Pathophysiology]
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