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Hepcidin is an interleukin-6 induced peptide hormone involved in iron metabolism and inflammation.1 Serum hepcidin level may distinguish anaemia due to chronic inflammation and/or iron deficiency in rheumatoid arthritis (RA) patients.2 Furthermore, some studies have suggested that serum hepcidin could reflect disease activity raising its measurement as a new surrogate biomarker of RA.3–6 These studies have several drawbacks (unreliable pro-hormone quantification, small number of patients).7 ,8 Therefore, we assessed the serum level of the mature form of hepcidin by ELISA (Bachem, St Helens, Merseyside, UK) in 791 individuals from the French cohort of early arthritis (ESPOIR) including 632 patients with RA fulfilling the American College of Rheumatology (ACR) - European League Against Rheumatism (EULAR) criteria at inclusion and 159 with undifferentiated arthritis in order to address whether hepcidin accurately reflects RA features, disease activity or radiographic disease progression.9 ,10
Beyond expected differences between RA and undifferentiated arthritis, serum hepcidin level was higher in RA (table 1). Hepcidin level was positively correlated with disease activity score in 28 joints (DAS28)-erythrocyte sedimentation rate at inclusion. However, the only variable used in calculating DAS28 that was correlated …
Contributors Conception and design of the study, analysis of the results, data interpretation: JS, FB, TS, JC, SK. Hepcidin measurements, analysis of the results, data interpretation: SF, JPB. Statistical analysis: SK, JS, TS, FB. Analysis of the results and data interpretation: FL, MM, OM. All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version. JS and FB had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding Grant support was from the French Society of Rheumatology and from Roche Chugai Pharma for serum hepcidin measurement. An unrestricted grant from Merck Sharp and Dohme (MSD) was allocated for the first 5 years. Two additional grants from INSERM were obtained to support part of the biological database. The French Society of Rheumatology, Abbott, Wyeth-Pfizer, Roche also supported the ESPOIR cohort study.
Competing interests None.
Patient consent Obtained.
Ethics approval Approval was obtained from Montpellier University Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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