Early Prognostic Factors Associated with the Efficacy of Infliximab Treatment for Patients with Rheumatoid Arthritis with Inadequate Response to Methotrexate. Issue 1 (June 2016)

• Record Type: Journal Article
• Authors: Hayashi, Satoko; Suzuki, Katsuya; Yoshimoto, Keiko; Takeshita, Masaru; Kurasawa, Takahiko; Yamaoka, Kunihiro; Takeuchi, Tsutomu
• Is Part Of: Rheumatology and therapy. Volume 3:Issue 1(2016)
• Page Start: 155
• Page End: 166
• Publication Date: 2016-06
• Subjects: Clinical efficacy -- Infliximab -- Interleukin-6 -- Prognostic serum marker -- Rheumatoid arthritis; Joints -- Diseases -- Treatment -- Periodicals; Connective tissues -- Diseases -- Treatment -- Periodicals; Rheumatology -- Periodicals; 616.72306
• DOI: 10.1007/s40744-015-0022-y
• Languages: English
• ISSNs: 2198-6576

Abstract

Abstract 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.