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Methotrexate Polyglutamation in a Myasthenia Gravis Clinical Trial.

Publication ,  Journal Article
Pasnoor, M; Heim, AJ; Herbelin, L; Statland, J; Dimachkie, MM; Becker, M; Barohn, RJ; Methotrexate in MG Investigators of the Muscle Group Study
Published in: Kans J Med
2020

INTRODUCTION: Methotrexate (MTX) is an immunosuppressive and anti-inflammatory drug used to treat rheumatoid arthritis (RA) and other autoimmune conditions. MTX is transported into cells, where glutamate moieties are added and is retained as methotrexate polyglutamates (MTXPGs). In the RA literature, it has been reported that the degree of polyglutamation correlates with the anti-inflammatory effect of MTX in RA. There are no prior studies evaluating the relationship between MTXPGs and myasthenia gravis (MG) outcome measures. The objective of this study was to assess the correlation between methotrexate (MTX) polyglutamates (MTXPGs) with Myasthenia Gravis (MG) outcome measures. METHODS: An analysis was done of blood drawn from patients enrolled in the 12-month randomized, placebo-controlled study of MTX in MG study. Red blood cell MTXPGs were measured via ultra-performance liquid chromatography and tandem mass spectrometry. MTXPG was correlated to MG outcome measures using Spearman Correlation Coefficient. A two-group t-test was used to determine the difference in MTXPG based on clinical outcome responder definitions. RESULTS: Twenty-one polyglutamate samples were analyzed of subjects on MTX while eight samples were analyzed from subjects on placebo. Pentaglutamate had the strongest correlation with the MG-ADL (0.99), while tetraglutamate had the strongest correlation with the QMG (0.54). Triglutamate had the strongest correlation with MGC (0.76). CONCLUSION: There were variable correlations between MTXPG1-5 and MG outcomes (rho range: 0.08 to 0.99). There are strong correlations between MTXPG and the MG-ADL, QMG, and MGC. Long chain methotrexate polyglutamates correlate better with MG outcomes.

Duke Scholars

Published In

Kans J Med

ISSN

1948-2035

Publication Date

2020

Volume

13

Issue

Suppl 2

Start / End Page

10 / 13

Location

United States
 

Citation

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ICMJE
MLA
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Pasnoor, M., Heim, A. J., Herbelin, L., Statland, J., Dimachkie, M. M., Becker, M., … Methotrexate in MG Investigators of the Muscle Group Study, . (2020). Methotrexate Polyglutamation in a Myasthenia Gravis Clinical Trial. Kans J Med, 13(Suppl 2), 10–13.
Pasnoor, Mamatha, Andrew J. Heim, Laura Herbelin, Jeffrey Statland, Mazen M. Dimachkie, Mara Becker, Richard J. Barohn, and Richard J. Methotrexate in MG Investigators of the Muscle Group Study. “Methotrexate Polyglutamation in a Myasthenia Gravis Clinical Trial.Kans J Med 13, no. Suppl 2 (2020): 10–13.
Pasnoor M, Heim AJ, Herbelin L, Statland J, Dimachkie MM, Becker M, et al. Methotrexate Polyglutamation in a Myasthenia Gravis Clinical Trial. Kans J Med. 2020;13(Suppl 2):10–3.
Pasnoor, Mamatha, et al. “Methotrexate Polyglutamation in a Myasthenia Gravis Clinical Trial.Kans J Med, vol. 13, no. Suppl 2, 2020, pp. 10–13.
Pasnoor M, Heim AJ, Herbelin L, Statland J, Dimachkie MM, Becker M, Barohn RJ, Methotrexate in MG Investigators of the Muscle Group Study. Methotrexate Polyglutamation in a Myasthenia Gravis Clinical Trial. Kans J Med. 2020;13(Suppl 2):10–13.

Published In

Kans J Med

ISSN

1948-2035

Publication Date

2020

Volume

13

Issue

Suppl 2

Start / End Page

10 / 13

Location

United States