Anticitrullinated protein antibody (ACPA) in rheumatoid arthritis: influence of an interaction between HLA-DRB1 shared epitope and a deletion polymorphism in glutathione S-transferase in a cross-sectional study.

SE-GSTM1 interactions In the VARA registry, there was significant additive interaction between SE and GSTM1 status (AP, 0.46; 95% CI, 0.20 to 0.73; P < 0.001), an interaction that was evident, albeit of borderline significance, in SONORA (AP, 0.38; 95% CI, 0.00 to 0.76; P = 0.050).

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In contrast, there was a significant additive interaction between SE positivity and ever smoking in the VARA registry, accounting for more than 50% of the overall risk of ACPA positivity in SE -positive smokers (AP, 0.58; 95% CI, 0.31 to 0.85; P < 0.001); there was also a nonsignificant trend to suggest multiplicative interaction ( P = 0.054).

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There was no evidence of a multiplicative SE-GSTM1 interaction in the VARA registry ( P = 0.25), although the P value of the product term approached significance in SONORA ( P = 0.06) (Table 3 ).

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