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.

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)

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Figure 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