Howard L. Weiner (United States of America)
Brigham and Women’s Hospital, Harvard Medical School NeurologyAuthor Of 1 Presentation
GENETIC FACTORS IMPLICATED IN THE RESPONSE TO FINGOLIMOD TREATMENT IN MULTIPLE SCLEROSIS PATIENTS: RESULTS FROM A PHARMACOGENETIC META-ANALYSIS
- Laura Ferrè (Italy)
Abstract
Background and Aims:
Multiple Sclerosis (MS) is a complex disease with high heterogeneity in terms of clinical presentation and treatment response. Pharmacogenetics can help to develop a more personalized approach and to improve disease management. We report the results of a GWAS on fingolimod-treated relapsing-remitting MS patients.
Methods:
We included 4 cohorts of fingolimod-treated MS patients from San Raffaele Hospital, Milan, Italy (OSR1: 246 patients, OSR2: 98 patients), Brigham and Women’s Hospital, Boston, USA (USA: 136 patients) and the Centre Hospitalier Universitaire de Toulouse, France (CHUT: 81 patients). We classified treatment response according to the NEDA (no evidence of disease activity) criterion at 2 years and time to first relapse (TFR). We performed a GWAS separately on each cohort and meta-analyzed them using a fixed-effect model.
Results:
three genome-wide significant variants were associated with TFR: rs9397818A on chr6 increases the risk of an earlier relapse and has an eQTL effect in whole blood on TFB1M, key to mitochondrial gene expression, and TIAM2, implicated in endothelial function and cell migration; rs2071572A is a risk allele intronic to synaptotagminV, involved in exocytosis of secretory vesicles, with an eQTL effect in brain cortex; finally the risk allele rs6124768A maps to CD40 locus and increases its expression according to a public eQTL database. No significant variants were identified in the NEDA analysis.
Conclusions:
genetic variants possibly implicated in cell migration, neuronal functions and immune response were associated with response to fingolimod. Functional studies are ongoing.