Effects of Antitumor Necrosis Factor Therapy on Osteoprotegerin, Neopterin, and sRANKL Concentrations in Patients with Rheumatoid Arthritis

الملخص EN

Background.

Rheumatoid arthritis is a systemic autoimmune disease characterized by joint erosions, progressive focal bone loss, and chronic inflammation.

Methods.

20 female patients with moderate-to-severe rheumatoid arthritis were treated with anti-TNF-antibody adalimumab in addition to concomitant antirheumatic therapies.

Patients were assessed for overall disease activity using the DAS28 score, and neopterin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) concentrations as well as osteoprotegerin (OPG) and soluble receptor activator of NF-κB ligand (sRANKL) concentrations were determined before therapy and at week 12.

Neopterin as well as OPG and sRANKL were determined by commercial ELISAs.

Results.

Before anti-TNF therapy patients presented with high disease activity and elevated concentrations of circulating inflammatory markers.

OPG concentrations correlated with neopterin ( r s = 0.494 , p = 0 .

027 ), but not with DAS28.

OPG concentrations and disease activity scores declined during anti-TNF-treatment (both p < 0 .

02 ).

Patients who achieved remission ( n = 7 ) or showed a good response according to EULAR criteria ( n = 13 ) presented with initially higher baseline OPG levels, which subsequently decreased significantly during treatment ( p = 0 .

018 for remission, p = 0 .

011 for good response).

Conclusions.

Adalimumab therapy was effective in modifying disease activity and reducing proinflammatory and bone remodelling cascades.