Effects of infliximab therapy on biological markers of synovium activity and cartilage breakdown in patients with rheumatoid arthritis.
BACKGROUND
Defining the remission criteria of rheumatoid arthritis (RA) remains a critical issue. Markers of synovium activity, urinary glucosyl-galactosyl-pyridinoline (Glc-Gal-PYD) and of cartilage destruction, urinary C-terminal crosslinking telopeptide of type II collagen (CTX-II) have been shown to reflect disease activity and joint damage progression in RA.


METHODS
The prospective study cohort comprised 66 RA patients treated with infliximab and methotrexate and 76 healthy controls. Measurements of urinary Glc-Gal-PYD and CTX-II were performed at baseline and at 1 year of infliximab therapy.


RESULTS
At baseline, urinary Glc-Gal-PYD and CTX-II levels were increased in patients with RA and correlated with modified Sharp scores and progression of joint damage. Patients with more progressive joint destruction had higher Glc-Gly-PYD and CTX-II baseline levels.


CONCLUSIONS
These markers reflected bone erosion evolution and might be useful for treatment monitoring and evaluation of RA. Markers remained high even in clinical responders after infliximab, suggesting persistence of synovitis.
Marotte
H
H
Hospices Civils de Lyon-bioMérieux Research Unit on Rheumatoid Arthritis, Hospital Edouard Herriot, Lyon, France. hubert.marotte@laposte.net
Gineyts
E
E
Miossec
P
P
Delmas
P D
PD
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000652:urine; D015415:Biomarkers / Q000378:metabolism; D024043:Collagen Type II / Q000378:metabolism; D003432:Cross-Linking Reagents; D004187:Disaccharides / Q000378:metabolism; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011725:Pyridines / Q000378:metabolism; D013583:Synovial Membrane / Q000378:metabolism*; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D015415:Biomarkers; D024043:Collagen Type II; D003432:Cross-Linking Reagents; D004187:Disaccharides; D011725:Pyridines; C505635:alpha-D-glucopyranosyl-(1-2)-beta-D-galactopyranosyl-O-pyridinoline; D000069285:Infliximab; D008727:Methotrexate