The efficacy of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) for rheumatoid arthritis (RA) patients was limited. However, there were no predictive markers for poor csDMARDs outcome. Clinical information of RA patients was collected and the high-mobility group box 1 (HMGB1) polymorphisms (rs4145277, rs2249825, rs1412125 and rs1045411) were examined. Among the 252 patients, 31.0% had no response of csDMARDs. Anti-citrullinated protein antibody (ACPA)-positive, C-reactive protein (CRP) and Disease Activity Score (DAS) 28- erythrocyte sedimentation rate (ESR) were the associated factors, which (DAC:DAS 28 > 4.7 and ACPA-positive and CRP > 7.1 mg/L) was used to predict poor csDMARDs outcome, the sensitivity and specificity was 87.2% and 60.9%, respectively. Among those DAC patients, the refractory RA rate in the rs2249825 GG genotype patients was 83.3%, the specificity was 98.5%. The clinical markers (DAC) and rs2249825 GG genotype can be used to predict poor csDMARDs outcome.

常规的合成疾病改良抗风湿药（csDMARDs）对类风湿关节炎（RA）患者的疗效有限。但是，尚无不良csDMARDs预后的预测指标。收集RA患者的临床信息，并检查高迁移率族box 1（HMGB1）多态性（rs4145277，rs2249825，rs1412125和rs1045411）。在252例患者中，有31.0％对csDMARD无反应。抗瓜氨酸化蛋白抗体（ACPA）阳性，C反应蛋白（CRP）和疾病活动评分（DAS）28-红细胞沉降率（ESR）是相关因素，其中（DAC：DAS 28> 4.7和ACPA阳性CRP> 7.1 mg / L）用于预测不良的csDMARDs结局，其敏感性和特异性分别为87.2％和60.9％。在这些DAC患者中，rs2249825 GG基因型患者的难治性RA率为83.3％，特异性为98.5％。临床标记（DAC）和rs2249825 GG基因型可用于预测不良的csDMARDs结果。