Background Biologics (BIO) have been developed the treatment of rheumatoid arthritis represent a remarkable advance over and beyond the conventional disease-modifying antirheumatic drugs (cDMARDs)1. However, 20–30% of rheumatoid arthritis (RA) patients using biologics are nonresponders or show only minor improvement.
Objectives Recently it was reported the concentration of serum cytokine was related the response of treatment for RA2,3. We investigate the relationships of it before taking first BIO and the change of disease activity in our series.
Methods One hundred nighty-nine RA patients have received BIO in our institutes from 2004 to 2013. Forty-one patients in BIO naive cases (infliximab 16 cases, etanercept 13, tocilizumab 9, adalimumab 3) were examined the concentration of serum tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6 before receiving first BIO by ELISA. They are estimated the transition of disease activity score (DAS)28/C-reactive protein (CRP) score (4) and clinical disease activity index (CDAI) one year after first BIO. They are 7 men and thirty-four women. Their mean age is 55 years (range 32-74), mean duration of RA affliction was 7.8 years (1-22).
Results The mean concentration of serum TNF-alpha and IL-beta, IL-6 was 16.2 (0.6-238) pg/ml,; 10 (10-11); 34.1 (0.5-303) before first BIO, respectively. The mean CRP levels, DAS28-CRP (4) and CDAI were 29 g/dl (range, 1–82), 4.9 (1.0-7.2) and 24.8 (0-67) before first BIO, which improved as 7 (0-34) g/dl, 3.1 (10-64) and 10.3 (0-30) one year after first BIO, respectively. EULAR response criteria were used, and there was a good response in twenty-eight patients (68%), a moderate response in eight (20%) and no response in five (12%), respectively, during the treatment period starting at the commencement of the BIO and one year after. Only the value of serum IL-6 was significantly related to the results of EULAR response and CRP before first BIO (p<0.05, Fig. 1). Four case in good response group was satisfied of criteria of remission using CDAI scoring (<2.8).
Conclusions The value of serum IL-6 before receiving BIO seems to have the potential marker for predicting the response of BIO treatment in RA patients.
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Takeuchi T, et al: ARD 2012; 71: 1583-1585.
Shimamoto K, et al: J Rheumatol 2013; 40:1074-1081.
Disclosure of Interest None declared