5 years ago

HLA-A 31:01 is not associated with the development of methotrexate pneumonitis in the UK population: results from a genome-wide association study

We read with interest the article by Furukawa et al1 suggesting an association between HLA-A 31:01 and methotrexate (MTX)-induced interstitial lung disease (ILD) in Japanese patients with rheumatoid arthritis (RA). MTX-ILD or MTX-pneumonitis (MTX-P) is an idiosyncratic hypersensitivity reaction to MTX that usually occurs within the first year of MTX therapy, inducing inflammation, cytokine release and the activation of CD4+ T-lymphocytes within the lung parenchyma,2–4 with a reported prevalence of 1% of the Caucasian RA population prescribed MTX.5

To investigate this association further, we conducted a genome-wide association study. Rheumatologists working within the National Health Service in the UK identified Caucasian patients with RA, who developed clinician diagnosed MTX-P (n=65). Caucasian controls, matched for age and gender, were identified from a prospective observational cohort study of patients starting MTX (n=195). In order to be eligible, controls were required to...

Publisher URL: http://ard.bmj.com/cgi/content/short/76/12/e51

DOI: 10.1136/annrheumdis-2017-211512

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