| Objective:To explore the association between adverse drug reactions(ADRs)and methylenetetrahydrofolate reductase(MTHFR)C677T gene polymorphism in patients with rheumatoid arthritis(RA)treated with MTX.Methods:178 RA patients who were treated in the Department of Rheumatology and Immunology of the Affiliated Hospital of North Sichuan Medical College from December 2018 to December 2019 were included.Single nucleotide polymorphism(SNP)of MTHFR[677C>T(rs1801133)]were detected by TaqMan fluorescence PCR.The adverse drug reactions that occurred in these 178 patients during treatment with MTX were reviewed,and the association between gene polymorphism and adverse drug reactions was analyzed.Results:1.ADRs statistical results:Among 178 RA patients,71 cases had adverse reactions,including 35 cases of hematological toxicity,31 cases of gastrointestinal reactions,7 cases of liver toxicity,6 cases of reproductive system toxicity,4 cases of renal toxicity,and others 7 cases.Some patients had two or more adverse reactions.2.Genotyping results:Of the 178 subjects,71 were CC genotypes,76 were CT genotypes,and 31 were TT genotypes.Of the 71 patients with adverse reactions,31 were CC genotypes,23 were CT genotypes,and 17 were TT genotypes.3.Association between gene polymorphism and ADRs:Among all genotypes of MTHFR C677T in RA patients,the incidence of MTX-related ADRs in TT genotype was the highest(about 54.8%),CC genotype was the second(43.7%),and CT genotype was the lowest(30.3%).The difference was statistically significant(P<0.05).However,there was no significant difference in the frequency of different types of ADRs in RA patients with different genotypes when using MTX(P>0.05).When analyzing the patient’s blood routine,it was found that the red blood cell volume(MCV)in the later period was higher than that in the initial period,but this change was not statistically different among all genotypes(P>0.05).Conclusions:1.The occurrence of MTX-related ADRs is related to MTHFR C677T gene polymorphism in RA patients,and individuals with TT genotype are more likely to suffer from MTX-related ADRs.2.There was no significant difference in the frequency of MTX-related different types of ADRs among all genotypes of MTHFR C677T in RA patients.3.The MCV of RA patients increased after the application of MTX,but this change was not statistically different among all genotypes of MTHFR C677T. |
