Early Prognostic Factors Associated with the Efficacy of Infliximab Treatment for Patients with Rheumatoid Arthritis with Inadequate Response to Methotrexate

被引：4

作者：

Hayashi S. ^{[1
]}

Suzuki K. ^{[1
]}

Yoshimoto K. ^{[1
]}

Takeshita M. ^{[1
]}

Kurasawa T. ^{[1
]}

Yamaoka K. ^{[1
]}

Takeuchi T. ^{[1
]}

机构：

[1] Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo

来源：

Rheumatology and Therapy | 2016年 / 3卷 / 1期

关键词：

Clinical efficacy; Infliximab; Interleukin-6; Prognostic serum marker; Rheumatoid arthritis;

D O I：

10.1007/s40744-015-0022-y

中图分类号：

学科分类号：

摘要：

Introduction: Early prognostic factors for the clinical response in patients with rheumatoid arthritis (RA) after 1 year of treatment with infliximab (IFX) as part of routine clinical practice were investigated. Methods: Thirty-five patients with RA with an inadequate response to methotrexate were enrolled and administered IFX (3–9 mg/kg, every 4–8 weeks). Serum trough levels of IFX and levels of 9 cytokines were measured at baseline and at 3, 6 months, and 1 year. Associations between these parameters and clinical indicators were statistically analyzed. Results: Serum trough levels of IFX and serum levels of interleukin (IL)-6 in the early phase of IFX treatment were investigated. Patients with low serum IL-6 achieved a higher clinical response as evaluated by the European League Against Rheumatism response criteria. Notably, the serum levels of IL-6 and IL-10 at baseline exhibited a significant positive correlation with disease activity at 1 year. Low serum levels of IL-6 and IL-10 at baseline were associated with low Disease Activity Score 28 erythrocyte sedimentation rate (DAS28-ESR). Cut-off values of IL-6 (5.45 pg/mL) and IL-10 and (1.68 pg/mL) enabled discrimination of DAS28-ESR remission from non-remission with high sensitivity and moderate specificity. Conclusion: Following the initiation of IFX treatment, early disease activity and remission were associated with serum levels of IL-6. Serum levels of IL-6 and IL-10 at baseline predict the efficacy after 1 year of treatment with IFX. Patients with high serum levels of IL-6 and IL-10 at baseline before IFX treatment might require more intensive therapy to achieve higher rates of clinical remission at 1 year. Funding: Eisai Co., Ltd. © 2015, The Author(s).

引用

页码：155 / 166

页数：11

共 20 条

[1]

Elliott M.J., Maini R.N., Feldmann M., Et al., Treatment of rheumatoid arthritis with chimeric monoclonal antibodies to tumor necrosis factor alpha, Arthritis Rheum, 36, pp. 1681-1690, (1993)

[2]

Tetta C., Camussi G., Modena V., Di Vittorio C., Baglioni C., Tumour necrosis factor in serum and synovial fluid of patients with active and severe rheumatoid arthritis, Ann Rheum Dis, 49, pp. 665-667, (1990)

[3]

Smolen J.S., Han C., Bala M., Et al., ATTRACT Study Group. Evidence of radiographic benefit of treatment with infliximab plus methotrexate in rheumatoid arthritis patients who had no clinical improvement: a detailed subanalysis of data from the anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study, Arthritis Rheum, 52, pp. 1020-1030, (2005)

[4]

Goekoop-Ruiterman Y.P., de Vries-Bouwstra J.K., Allaart C.F., Et al., Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial, Arthritis Rheum, 58, pp. S126-S135, (2008)

[5]

Smolen J.S., Han C., van der Heijde D.M., Et al., Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset (ASPIRE) Study Group. Radiographic changes in rheumatoid arthritis patients attaining different disease activity states with methotrexate monotherapy and infliximab plus methotrexate: the impacts of remission and tumor necrosis factor blockade, Ann Rheum Dis, 68, pp. 823-827, (2009)

[6]

Yamanaka H., Tanaka Y., Sekiguchi N., Et al., Retrospective clinical study on the notable efficacy and related factors of infliximab therapy in a rheumatoid arthritis management group in Japan (RECONFIRM), Mod Rheumatol, 17, pp. 28-32, (2007)

[7]

Takeuchi T., Miyasaka N., Inoue K., Abe T., Koike T., RISING study. Impact of trough serum level on radiographic and clinical response to infliximab plus methotrexate in patients with rheumatoid arthritis: results from the RISING study, Mod Rheumatol, 19, pp. 478-487, (2009)

[8]

Takeuchi T., Miyasaka N., Tatsuki Y., Et al., Inhibition of plasma IL-6 in addition to maintenance of an efficacious trough level of infliximab associated with clinical remission in patients with rheumatoid arthritis: analysis of the RISING Study, Ann Rheum Dis, 71, pp. 1583-1585, (2012)

[9]

Takeuchi T., Miyasaka N., Inui T., Et al., Prediction of clinical response after 1 year of infliximab therapy in rheumatoid arthritis based on disease activity at 3 months: post hoc analysis of the RISING study, J Rheumatol., 42, 4, pp. 599-607, (2015)

[10]

Edrees A.F., Misra S.N., Abdou N.I., Anti-tumor necrosis factor (TNF) therapy in rheumatoid arthritis: correlation of TNF-alpha serum level with clinical response and benefit from changing dose or frequency of infliximab infusions, Clin Exp Rheumatol, 23, pp. 469-474, (2005)

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