Effects of tumor necrosis factor-α inhibitors in mothers and daughters concordant for HLA-B27-positive ankylosing spondylitis

OBJECTIVES: Pharmacogenomics is considered as the new frontier to predict the response to treatments and it can also be based on the comparison of family members being treated for the same condition. No data are available on the impact of anti-tumour necrosis factor (TNF)-α therapies in members of the same family with ankylosing spondylitis (AS). METHODS: We describe three mother-daughter couples concordant for AS and HLA-B27, both treated with TNF-α inhibitors, for whom the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP were evaluated during a follow-up of 24 months. RESULTS: All patients manifested improvements of all scores, but the daughters had a more prominent effect achieving faster complete disease remission. CONCLUSIONS: We hypothesise that longer standing chronic inflammation and older age may cause a less prompt and effective response to treatment in SA when compared with their genetically related controls.