title: Changes in plasma IL-6, plasma VEGF and serum YKL-40 during Treatment with Etanercept and Methotrexate or Etanercept alone in Patients with Active Rheumatoid Arthritis Despite Methotrexate Therapy.
abstract: Changes in plasma IL-6, plasma VEGF and serum YKL-40 were determined in rheumatoid arthritis (RA) patients during treatment with etanercept alone or in combination with methotrexate. Twenty-five patients with active RA (DAS28 >/= 3.2) were randomized to receive etanercept (25 mg sc. biweekly) plus methotrexate (n = 12) or etanercept alone (n = 13). Plasma IL-6, plasma VEGF and serum YKL-40 were determined by ELISA. The 3 biomarkers and DAS28 scores were evaluated at baseline and after 4, 8, 12 and 16 weeks of treatment. At inclusion all patients had significantly (p < 0.001) elevated plasma IL-6, plasma VEGF and serum YKL-40 compared to healthy subjects. Eighteen patients responded to treatment (pooled data from both treatment groups), and they had significant (p < 0.05 to p < 0.001) decreases in plasma IL-6, plasma VEGF, serum YKL-40, ESR and DAS28 after 4 weeks of treatment and throughout the study (except serum YKL-40 at week 16). Plasma IL-6 showed the largest reductions. Non-responders had unchanged biomarkers. At week 16 the patients with DAS28 < 3.2 had lower levels compared to baseline values in plasma IL-6 (p = 0.005), plasma VEGF (p = 0.014), and ESR (p = 0.024).Plasma IL-6, plasma VEGF and serum YKL-40, which reflect different aspects of the inflammatory process, may provide useful information regarding early differentiation of responders from non-responders.
authors.affiliation: Department of Rheumatology, Copenhagen University Hospital at Herlev, Denmark.
authors.forename: Lene Surland
authors.initials: LS
authors.lastname: Knudsen
authors.forename: Merete Lund
authors.initials: ML
authors.lastname: Hetland
authors.forename: Julia Sidenius
authors.initials: JS
authors.lastname: Johansen
authors.forename: Henrik
authors.initials: H
authors.lastname: Skjødt
authors.forename: Niels Daugaard
authors.initials: ND
authors.lastname: Peters
authors.forename: Ada
authors.initials: A
authors.lastname: Colic
authors.forename: Karin
authors.initials: K
authors.lastname: Grau
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Nielsen
authors.forename: Mikkel
authors.initials: M
authors.lastname: Ostergaard