The-308 TNFα and the -174 IL-6 promoter polymorphisms associate with effective anti-TNFα treatment in seronegative spondyloarthritis

The genetic predisposition to a long-term efficacy of anti-tumor necrosis factor (TNF)alpha treatment in seronegative spondyloarthritis (SpA) was investigated by analysing the possible correlation between several single nucleotide gene polymorphisms and the retention rate of anti-TNF alpha therapies. We compared patients needing to switch the first anti-TNF alpha (Sw, No. 64) within at least 12 months of follow-up with patients not needing to switch (NSw, No. 123), observing at least 6 months of treatment to establish anti-TNF alpha failure, leading to treatment change. Response to treatment was evaluated by standardised criteria (BASDAI for axial involvement, DAS28-EULAR for peripheral involvement). The TNF alpha -308 A allele and the interleukin (IL)-6 -174GG homozygosis resulted as independent biomarkers predicting survival of the first anti-TNF alpha therapy in SpA patients (P = 0.007, odds ratio (OR): 4.4, 95% confidence interval (CI) = 1.5-13.1 and P = 0.035, OR: 2.1, 95% CI = 1.1-4.4). Also, the male gender (P = 0.001, OR: 3.4, 95% CI = 1.6-7.1) associated with the NSw phenotype, whereas no association was found either with the specific diagnosis or the predominant joint involvement.