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Genetic Predispositions of Glucocorticoid Resistance and Therapeutic Outcomes in Polymyalgia Rheumatica and Giant Cell Arteritis

T. Smutny, I. Barvik, T. Veleta, P. Pavek, T. Soukup,

. 2019 ; 8 (5) : . [pub] 20190427

Language English Country Switzerland

Document type Journal Article, Review

Persistent link   https://www.medvik.cz/link/bmc19029062

Grant support
00179906 MH CZ - DRO UHHK
PROGRES Q40-15, PROGRES Q47 Charles University research projects
[No. CZ.02.1.01/0.0/0.0/16_019/0000841] co-funded by ERDF EFSA-CDN

Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are closely related chronic inflammatory diseases. Glucocorticoids (GCs) are first-choice drugs for PMR and GCA, although some patients show poor responsiveness to the initial GC regimen or experience flares after GC tapering. To date, no valid biomarkers have been found to predict which patients are at most risk for developing GC resistance. In this review, we summarize PMR- and GCA-related gene polymorphisms and we associate these gene variants with GC resistance and therapeutic outcomes. A limited number of GC resistance associated-polymorphisms have been published so far, mostly related to HLA-DRB1*04 allele. Other genes such ICAM-1, TLR4 and 9, VEGF, and INFG may play a role, although discrepancies are often found among different populations. We conclude that more studies are required to identify reliable biomarkers of GC resistance. Such biomarkers could help distinguish non-responders from responders to GC treatment, with concomitant consequences for therapeutic strategy.

References provided by Crossref.org

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