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THU0110 The Effect of Subcutaneous (SC) Methotrexate (MTX) and Adalimumab (ADA) on Cytokine Profile in MTX-Naive Patients with Early Rheumatoid Arthritis (RA)
  1. A.S. Avdeeva,
  2. A.A. Novikov,
  3. E.N. Aleksandrova,
  4. D.E. Karateev,
  5. E.L. Luchihina,
  6. E.L. Nasonov
  1. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation


Objectives To evaluate the changes in cytokine profile in MTX-naive patients (pts) with early RA during MTX and ADA+MTX therapy

Methods Serum samples from 45 MTX-naive adults with early RA who received MTX (35 woman, mean age 53,5; 46-59,5 years, mean disease duration 7,0; 4,0-11,5 months, mean DAS 28 5,8; 4,9-6,4, RF positive-91%, anti-CCP positive-96%) were analyzed for selected markers of inflammation. The levels of IL-1b, IL-1Pa, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12, IL-13, IL-15, IL-17, Eotaxin, FGF-basic, IFN-γ, IP-10, MCP-1, MIP-1α, MIP-1β, RANTES, TNF-α, VEGF (pg/ml) were tested by multiplex technology xMAP at baseline and weeks 12 and 24

Results After 3 months the efficacy of SC MTX have met the goal (EULAR response) in 23 (51%) of pts (not switching group). Switching to combination with ADA was required in 22 (49%) of pts (switching group). The relations between achievement of LDA or remission according to treatment regimens are shown in the table 1.

Table 1

In not-switching group MTX induced reduction in proinflammatory (IL-6, -17, TNF-α), anti-inflammatory (IL-4, -5, -9, -13) cytokines, chemokines (IP-10) and growth factors (FGF) at week 12; IL-6, IL-9, IP-10, PDGF-bb at week 24 (p<0,05). The serum levels of IL-10, IFN-γ increased at week 24 (p<0,05).

In switching group MTX induced reduction in IL-6, IL-1Pa, IP-10 at week 12 (p<0,05). ADA induced significant reduction in proinflammatory (IL-12), anti-inflammatory (IL-9) cytokines, chemokines (IP-10, MCP-1, MIP-1β) and growth factors (VEGF), and increased in IL-10 and IFN-γ (week 12 of treatment) (Fig. 1)

Conclusions Clinical efficacy of SC MTX therapy is associated with reduced of proinflammatory cytokines, chemokines and growth factors at weeks 12-24 of therapy. ADA therapy is characterized by a decrease in disease activity and reduction chemokine type cytokines in pts with early RA

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.2698

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