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Relationship between SLCO1B1 polymorphisms and methotrexate intolerance in Mexican children with juvenile idiopathic arthritis

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Abstract

Introduction

The most frequent adverse events (AEs) of methotrexate (MTX) are gastrointestinal symptoms and hepatotoxicity, which can affect its adherence, leading to reduced effectiveness. The SLCO1B1 gene codes for a liver protein (OATP1B1) responsible for drug transportation. Genetic variations within the SLCO1B1 gene locus impact drug transport, leading to altered pharmacokinetic profiles, delayed MTX clearance, and increased risk of toxicity. This study aimed to determine the association between single nucleotide polymorphisms (SNPs) in the SLCO1B1 gene (rs4149056, rs2306283) with the development of AEs in patients with juvenile idiopathic arthritis (JIA) treated with MTX.

Method

We performed an observational retrospective study to analyze the relationship between SNPs in the SLCO1B1 gene and the development of AEs in pediatric patients treated with MTX for JIA.

Results

Thirty patients with JIA were included, 22 females (73.3%), with a median age of 11 years (IQR 8.3–15). The most frequent JIA subtype was rheumatoid factor-positive polyarthritis (36.7%). Twenty patients (66.7%) reported AEs. The *1B haplotype was the most frequent in this group (53.3%) and conferred a higher risk of developing AEs (OR = 3.89, 95% CI = 1.23 -12.29, p = 0.03).

Conclusions

Patients with the allele *1B may benefit from lower doses of MTX. SLCO1B1 genotyping is a promising technique to identify patients at higher risk of AEs during treatment with MTX, thus requiring dose optimization.
Key Points
• The most frequent SLCO1B1 haplotype in our population was *1B, also associated with a higher risk of developing adverse events (OR=3.89, 95% CI=1.23 -12.29, p=0.03).
• SLCO1B1 genotyping is a promising tool to help identify patients at higher risk of MTX-related AEs.
Title
Relationship between SLCO1B1 polymorphisms and methotrexate intolerance in Mexican children with juvenile idiopathic arthritis
Authors
Jimena Garcia-Silva
Beatriz Silva-Ramirez
Ana V. Villarreal-Treviño
Viviana Mata-Tijerina
Nadina E. Rubio-Perez
Fernando Garcia-Rodriguez
Publication date
04-11-2024
Publisher
Springer International Publishing
Published in
Clinical Rheumatology / Issue 12/2024
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-024-07221-x
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