The relationship between tumour necrosis factor (TNF)-α promoter and IL12B/IL-23R genes polymorphisms and the efficacy of anti-TNF-α therapy in psoriasis: a case-control study

BackgroundAntitumour necrosis factor (anti-TNF)- agents can be used successfully to treat patients with psoriasis and other inflammatory diseases. However, very few studies have examined the relationship between TNF- polymorphisms and the response to anti-TNF- agents. ObjectivesTo study the association of single nucleotide polymorphisms (SNPs) of the TNF- promoter and IL12B/IL23R genes with the response to anti-TNF- in patients with psoriasis. MethodsSNPs for the TNF- promoter and IL12B/IL23R genes, and the presence of the HLA-Cw6 haplotype were genotyped for 109 patients. We studied the association between these SNPs and the efficacy of treatment at 3 and 6months [Psoriasis Area and Severity Index (PASI) and body surface area (BSA)]. ResultsPatients with the TNF--238GG genotype more frequently achieved a PASI75 at 6months (825% vs. 588%, P=0049). At 6months, patients with the TNF--857CT/TT genotypes showed greater improvements in PASI score and BSA (831% vs. 927%, P=0004; 827% vs. 926%, P=0009) and more frequently achieved PASI75 (714% vs. 963%, P=0006). More patients with the TNF--1031TT genotype achieved PASI75 at 3months (908 vs. 757, P=0047) and 6months (855% vs. 657%, P=0038) and demonstrated superior improvements in PASI at 6months (899% vs. 787%, P=0041). Patients with the IL23R-GG genotype (rs11209026) achieved PASI90 at 6months more frequently (663% vs. 0, P=0006) and the improvement of the PASI score was also greater (868% vs. 678%, P=0013). Patients with the HLA-Cw6 haplotype showed poorer response than those without this haplotype. ConclusionThis study identified a relationship between certain TNF- and IL12B/IL23R polymorphisms and the short-term response to anti-TNF- drugs. If these results are confirmed, this information will allow for stratified consent with more accurate prediction of response/personalized choice of treatment hierarchy for the patient.