The relationship between serum-soluble interleukin-2 receptor and radiological evolution in psoriatic arthritis patients treated with cyclosporin-A.
Aims of the study to evaluate the radiologically detected progression of joint damage in patients with psoriatic arthritis (PA) treated with cyclosporin-A (CsA) and to look for clinical and/or immunological parameters that might predict outcome. Twenty-four out-patients suffering from active PA entered a 2-year open prospective study on low-dose CsA (starting dose 3 mg/kg/day). Fifteen patients completed the study. Plain radiographs of hands and feet at study entry and at the end of follow-up were compared for the number of eroded joints. Serum-soluble IL-2 receptor (sIL-2R) levels were available in 13/15 patients before CsA therapy, after 6 months and after 2 years. The mean number of eroded joints per patient increased significantly during the study period (P = 0.017). Nine patients had less than two new eroded joints (responders) while the remaining six patients had five or more new eroded joints (non-responders). Serum sIL-2R levels were in the normal range after 6 months and 2 years of CsA treatment in all the responder patients and were above the 95th percentile of the control population in the six non-responders. We did not find any other demographical, clinical, radiological or laboratory parameter predictive of outcome in conclusion. (1) CsA seems to be able to control the 2-year progression of the radiologically measured damage in peripheral joints in 60% of PA patients. (2) A normal serum sIL-2R level after 6 months of therapy seems to have a prognostic value for a good outcome in PA patients treated with CsA.
Servizio di Reumatologia, Azienda Ospedaliera Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
P
P
Macchioni
L
L
Boiardi
T
T
Cremonesi
B
B
Battistel
M
M
Casadei-Maldini
E
E
Beltrandi
R
R
Mancini
C
C
Salvarani
D000284:Administration, Oral; D015535:Arthritis, Psoriatic / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D015375:Receptors, Interleukin-2 / Q000097:blood*; D013640:Tarsal Joints / Q000000981:diagnostic imaging
D015415:Biomarkers; D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2; D016572:Cyclosporine