Genes Dictate Response to Lupus Drugs

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MONDAY, Feb. 13 (HealthDay News) -- Drugs commonly used to fight malaria are also used by lupus patients to fight that illness. Now a new study shows that anti-malarials are most effective in lupus patients genetically prone to specific levels of inflammatory compounds called cytokines.

Patients with high levels of tumor necrosis factor (TNF)-alpha and low levels of another cytokine, IL-10, may benefit most from anti-malarials, according to a Spanish study published Sunday in the journal Arthritis Research & Therapy.

The findings may prove useful in identifying lupus patients most likely to benefit from taking anti-malarials, the researchers said.

In lupus patients, anti-malarial drugs can also bring blood levels of inflammatory TNF back to normal. This study found that the drugs are more effective in lupus patients with two specific genetic variations on the TNF-alpha and IL-10 genes.

Researchers at the Universidad de Oviedo compared the outcomes of 192 lupus patients to those of 343 healthy people in a control group.

Both groups were checked for two specific gene variations on the TNF-alpha and IL-10 genes. The researchers also measured TNF-alpha serum levels in 171 of the lupus patients and 215 people in the control group.

As expected, overall TNF-alpha serum levels were higher in the lupus patient group (33.57 pg/ml) than in the control group (19.66 pg/ml). However, lupus patients who'd been taking anti-malarials for at least three months prior to the study had TNF-alpha serum levels of 16.64 pg/ml -- similar to those of healthy individuals. Lupus patients who had not been taking the drugs had levels of 60.78 pg/ml.

In lupus patients with both genetic variations on the TNF-alpha and IL-10 genes, TNF-alpha levels were four times lower if they had been taking anti-malarials. For lupus patients without the genetic variations, there was a much less significant difference in TNF-alpha levels between those taking the drugs and those not on the therapy.

The researchers concluded that lupus patients with both genetic variations were four times more likely to respond to treatment with anti-malarials than other lupus patients.

More information

The Lupus Foundation of America has more about anti-malarials and lupus.