JAK2 Mutation May Predict Response and Guide First Line Treatment in Rheumatoid Arthritis
Condition: Response Assessment in Newly Diagnosed RA Patients at 3rd Month Was Evaluated by DAS28 and ACR in Relation to JAK Expression
MeSH terms: Arthritis; Arthritis, Rheumatoid
Study type: Interventional

Summary: 
      This study included 76 newly diagnosed RA patients and 50 matched controls. Basal JAK2
      mutation was assessed by PCR in blood samples, TNF-α and IL 6 were measured by ELISA in serum
      of patients and controls. All patients started therapy with conventional synthetic DMARDs
      (including methotrexate). Response assessment at 3rd month was evaluated by DAS28 and ACR
      response criteria. JAK2 mutation was correlated with different clinical and laboratory
      parameters of patients.
    

Detailed description: 
      PCR detection of the JAK-2 V617F mutation using ASO specific PCR Genetic marker:

      The detection of jak2 V617F mutation were done by using the following primers (JAK2 Reverse:
      5' CTGAATAGTCCTACAGTGTTTTCAGTTTCA 3', JAK2 Forward (specific): 5'
      AGCATTTGGTTTTAAATTATGGAGTATATT 3' and JAK2 Forward (internal control): 5'
      ATCTATAGTCATGCTGAAAGTAGGAGAAAG 3'). Cycling conditions were 35 cycles with annealing
      temperature 58.5oC flowed by agarose gel 2% electrophoresis for bands detections.

      All patients started treatment by conventional synthetic DMARDs (including methotrexate).
      Response assessment at 3rd month was evaluated by DAS28 and ACR response criteria. JAK2
      mutation was correlated with different clinical and laboratory parameters of patients.

      The Disease Activity Score (DAS) and the DAS28 have been developed to measure disease
      activity in RA both in daily clinical practice as well as in clinical trials on a group as
      well as individual level. The DAS/DAS28 is a continuous measure of RA disease activity that
      combines information from swollen joints, tender joints, acute phase response and general
      health The DAS28 is a measure of disease activity in rheumatoid arthritis (RA). DAS stands
      for 'disease activity score' and the number 28 refers to the 28 joints that are examined in
      this assessment. questionnaires (e.g. the HAQ which assesses function), X-rays, and newer
      imaging techniques such as ultrasound and MRI.

      The ACR20 is a composite measure defined as both improvement of 20% in the number of tender
      and number of swollen joints, and a 20% improvement in three of the following five criteria:
      patient global assessment, physician global assessment, functional ability measure [most
      often Health Assessment Questionnaire (HAQ)], visual analog pain scale, and erythrocyte
      sedimentation rate or C-reactive protein (CRP). ACR50 and ACR70 are the same instruments with
      improvement levels defined as 50% and 70% respectively versus 20% for ACR20.
    

Intervention name(s): JAK expression
Intervention type(s): Diagnostic Test
Intervention description(s): JAK2 assessment in blood by PCR
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: Single (Investigator)
Primary purpose: Other