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Toxigenetic Score of Weisman et al for Methotrexate

Description

Weisman et al reported a toxigenetic score for predicting methotrexate-related toxicity. This is based on changes in folate-dependent enzymes. The authors are from Cedars-Sinai Medical Center, University of California Los Angeles, Prometheus Laboratories, Center for Rheumatology in Albany and Radiant Research.


Methotrexate is an antifolate agent.

 

Risk genotypes:

(1) MTHFR 677TT (methylenetetrahydrofolate reductase)

(2) SHMT1 1420CC (serine hydroxymethyltransferase)

(3) TSER *2/*2(thymidylate synthase)

(4) ATIC 347GG (amino imidazole ribonucleotide transformylase)

 

Finding

Points

absent

0

present

1

 

total score =

= SUM(points for all 4 risk genotypes)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• The higher the score the greater the risk of methotrexate toxicity.

• A score of 3 had about a 7-fold increase in side effects when compared to score 0.


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