Antibodies against cyclic citrullinated peptide don't decrease after 6 months of infliximab treatment in refractory rheumatoid arthritis.
Anti-citrullinated peptide antibodies (ACPA) and the rheumatoid factor (RF) are well-established serological markers for rheumatoid arthritis (RA). ACPA are very useful in the diagnosis of RA, especially at the early stages of the disease when ACPA have a greater diagnostic value than RF. The aim of the study was to assess the influence of infliximab treatment on RF IgM and ACPA serum levels and RA activity during 6 months of treatment. Thirty-two patients with refractory RA were treated with infliximab during a 6-month period. At baseline, 3 and 6 months of treatment the patients were examined for the number swollen and tender joints out of 28 (SJC, TJC) and the visual analogue scale of arthritis activity according to the patient (VAS). Serum samples were tested for erythrocyte sedimentation rate (ESR), C-reactive protein level (CRP), ACPA and RF IgM. The disease activity score (DAS-28) parameter was also calculated at the same time. During the course of our study, we observed statistically significant improvement in ESR, CRP, TJC, SJC, VAS DAS-28, and RF IgM after 3 and 6 months of infliximab treatment when compared to the baseline, whereas the ACPA level remained unchanged after 3 and 6 months of treatment (P = 0.96 and P = 0.85). The changes in the ACPA level are not a factor for evaluation of successful infliximab treatment but the changes in RF IgM are. According to different behavior of these antibodies during infliximab treatment, we suggest that the roles of ACPA and RF in the pathogenesis of RA are different.
Kolarz
Bogdan
B
Department of Family Medicine, Medical University of Lublin, ul. Staszica 11, 20-081 Lublin, Poland. kolbo@wp.pl
Majdan
Maria
M
Dryglewska
Magdalena
M
Darmochwal-Kolarz
Dorota
D
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D002738:Chloroquine / Q000627:therapeutic use; D004351:Drug Resistance / Q000276:immunology; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology*; D012217:Rheumatoid Factor / Q000097:blood / Q000276:immunology; D055815:Young Adult
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D001323:Autoantibodies; D005938:Glucocorticoids; D007075:Immunoglobulin M; D007166:Immunosuppressive Agents; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D002738:Chloroquine; D012217:Rheumatoid Factor; D000069285:Infliximab; D008727:Methotrexate
Ann Rheum Dis. 2008 Sep;67(9):1347-50
18388157
Arthritis Res Ther. 2006;8(1):R3
16356192
Arthritis Rheum. 2004 Jul;50(7):2113-21
15248208
Arthritis Res Ther. 2006;8(1):R19
16507117
Arthritis Rheum. 2003 Oct;48(10):2741-9
14558078
Arthritis Rheum. 2004 Dec;50(12):3776-82
15593224
J Immunol. 1999 Aug 1;163(3):1521-8
10415055
Ann Rheum Dis. 2005 Feb;64(2):299-302
15166003
Ann Rheum Dis. 2004 Oct;63(10):1218-21
15361374
Scand J Rheumatol. 2003;32(4):197-204
14626625
Arthritis Rheum. 2000 Aug;43(8):1831-5
10943873
Ann Rheum Dis. 2005 Aug;64(8):1224-6
16014683
Arthritis Res Ther. 2007;9(5):R103
17922913
Ann Rheum Dis. 2009 Jan;68(1):69-74
18375541
Arthritis Rheum. 2000 Jan;43(1):155-63
10643712
Ann Rheum Dis. 2003 Sep;62(9):870-4
12922961
Joint Bone Spine. 2009 May;76(3):248-53
19208451
Rheumatol Int. 2005 Nov;26(1):58-62
15726373
Biochem Biophys Res Commun. 1998 Feb 24;243(3):641-6
9500980
J Rheumatol. 2008 Mar;35(3):425-8
18322974
Ann Rheum Dis. 2004 Dec;63(12):1587-93
15547083
Arthritis Rheum. 2007 Oct;56(10):3226-35
17907167
Arthritis Rheum. 2004 Feb;50(2):380-6
14872479
Arthritis Rheum. 2005 Nov;52(11):3424-32
16255019
Ann Rheum Dis. 2002 Aug;61(8):723-5
12117680
Lancet. 1999 Dec 4;354(9194):1932-9
10622295
J Rheumatol. 2006 Mar;33(3):497-500
16511906
Science. 2004 Oct 8;306(5694):279-83
15345777
J Rheumatol. 1998 Mar;25(3):417-26
9517757
Annu Rev Med. 2000;51:207-29
10774461
Ann Rheum Dis. 2005 Dec;64(12):1744-9
15843452
Ann Rheum Dis. 2005 Jul;64(7):1003-8
15958758