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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Distribution of metabolites methotrexate (MTX) in red blood cells of patients with rheumatoid arthritis (RA)

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  • Galina Gridneva - V.A. Nasonova Rheumatology Research Institute, Moscow
  • Eugenia Aronova - V.A. Nasonova Rheumatology Research Institute, Moscow
  • Anastasia Kudryavtseva - V.A. Nasonova Rheumatology Research Institute, Moscow
  • Natalia Baymeeva - Mental Health Centre, Moscow
  • Yury Muraviev - V.A. Nasonova Rheumatology Research Institute, Moscow
  • Elena Samarkina - V.A. Nasonova Rheumatology Research Institute, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocRA.13

doi: 10.3205/21dgrh120, urn:nbn:de:0183-21dgrh1200

Published: September 14, 2021

© 2021 Gridneva et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: The concentration of MTХ polyglutamates (MTХPG) in red blood cells may become an objective therapy response predictor. The aim of this cross-section study was to determinate the correlation between the level of MTХPG in patients taking methotrexate in stable doses, on the therapeutic response.

Methods: The study included 60 (44 women and 16 men) adult (>18 years old) RA patients according to ACR/EULAR 2010 criteria. Group 1 (n = 30) had good therapeutic effect on MTX therapy according to the EULAR criteria of the treatment effectiveness. Group 2 (n = 30) had moderate effect or no effect. MTXPG (total and MTXPG with 1,2,3,4 or 5 glutamate residues) were determined in erythrocytes by mass spectrometry. The therapy was: MTX subcutaneously at least 20 mg/week, for 12-225 weeks before including.

Results: The weekly dose of MTX was comparable in all patients. It was established that the levels of total MTXPG and MTXPG1,2,3,5 in red blood cells did not correlate with the therapeutic effec of MTX. At the same time, the level of MTPXG4 was significantly higher (p = 0.023) in patients of group 1 (26.4 ± 6.1 nmol/l) compared with patients in group 2 (22.1 ± 6.8 nmol/l). ROC-analyses showed that MTXPG4 values ??below 22.5 nmol/l matched to the absence of the therapeutic effect of MT. The area under the curve 0.672, (CI 95 0.536-0.808); p=0.022. Specificity - 53.3%, sensitivity - 77%.

Conclusion: The target ratio of MTXPG4 in erythrocytes to achieve a good therapeutic response is 22.5 nmol/L or more.

Disclosures: None declared