Background RA- is a chronic inflammatory disease mediated by the production of proinflammatory cytokines, which leads to the destruction of bone and cartilage tissue in multiple joints. TCZ - humanized anti-interleukin-6 (IL-6) receptor monoclonal antibody is effective and safe drug for the treatment of RA, prevents progressive joint destruction and causes decrease biochemical markers bone and cartilage degradation.
Objectives To mark the impact of the TCZ therapy on bone destruction and the level of MMP3 in RA patients (pts).
Methods Data were obtained from the first Russian open-label, Phase IV, multicenter 24 week study of the efficacy and safety of TCZ in RA. 42 pts with RA (32 woman, mean age 50,5; 43,0-55,0 years, mean disease duration 56,5; 23,0-81,0 months, mean DAS 28 6,4; 5,8-7,05) received 6 intravenous TCZ infusions (8 mg/kg) every 4 weeks, in combination with DMARDs and glucocorticoids. Erythrocyte sedimentation rate – ESR (mm/hr) was determined by Westergren method; antibodies to modified citrullinated vimentin – anti-MCV (U/ml) and matrix metalloproteinase -MMP 3 (ng/ml) were tested using ELISA. Radiographs of the hands and feet were performed at baseline and in 48 weeks. Damage was quantifi by using van der Heijde-modified Sharp scores. Radiographic non-progression was defined as a change in total modified Sharp score (mTSS) ≤0.
Results The baseline mTSS [Me (interquartile range)] was 78 (46-122), erosion score – 10,5 (2-35), by 48-th week of treatment: the mTSS - 80 (44-130), the erosion score 13,5 (1,5-34), radiographic progression was observed in 9 pts (22,5%).
All pts were divided into two groups by the level of anti-MCV before the therapy. RA pts, who had high positive basal level anti-MCV observed a lower incidence of radiographic progression (20%) and a significant decrease in MMP 3, compared with anti-MCV - negative / low positive pts (50% p = 0,05) (Table 1).
Conclusions Anti-MCV high positive pts respond better to therapy TCZ (decline of level of MMP-3 and less percent of the radiographic progression) compared with anti-MCV negative/ low positive pts.
Disclosure of Interest None Declared