Low baseline interleukin-17A levels are associated with better treatment response at 12 weeks to tocilizumab therapy in rheumatoid arthritis patients.
T helper 17-related cytokines have been implicated in rheumatoid arthritis (RA) pathogenesis. The study aimed to identify cytokines associated with the treatment response of RA patients to tocilizumab (TCZ), a humanized monoclonal antibody against the interleukin- (IL-) 6 receptor. As an independent substudy of the 24-week, randomized, double-blinded CWP-TCZ301 trial of TCZ in RA patients with an inadequate response to disease-modifying antirheumatic drugs, serum levels of cytokines including tumor necrosis factor-alpha, IL-17A, IL-21, IL-23, IL-6, and soluble IL-6 receptor were measured. Baseline IL-17A levels were significantly lower in RA patients who achieved disease activity score 28 (DAS28) remission at 12 weeks of TCZ treatment, compared to patients not in remission. Patients were stratified into IL-17A low group and IL-17A high group. Significantly more patients in the IL-17A low group achieved remission as compared to the IL-17A high group (47.6 versus 17.4%, P = 0.032). DAS28 improvement was significantly better in the IL-17A low group than in the IL-17A high group at 12 weeks (P = 0.045) and 24 weeks (P = 0.046) after adjustment. Other baseline cytokines were not associated with treatment response to TCZ. The data demonstrate that low baseline IL-17A levels are associated with better clinical response to TCZ treatment in RA patients.
Division of Rheumatology, Seoul National University Hospital, Seoul, Republic of Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Republic of Korea.
Sang Jin
SJ
Lee
Division of Rheumatology, Inha University Hospital, Incheon, Republic of Korea.
Won
W
Park
Division of Rheumatology, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Republic of Korea.
Sung Hwan
SH
Park
Division of Rheumatology, Eulji University Hospital, Daejeon, Republic of Korea.
Seung-Cheol
SC
Shim
Division of Rheumatology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Han Joo
HJ
Baek
Division of Rheumatology, Hanyang University Medical Center, Seoul, Republic of Korea.
Dae-Hyun
DH
Yoo
Division of Rheumatology, Hallym University Medical Center, Anyang, Republic of Korea.
Hyun Ah
HA
Kim
Division of Rheumatology, Yonsei University Health System, Seoul, Republic of Korea.
Soo Kon
SK
Lee
Division of Rheumatology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Yun Jong
YJ
Leee
Division of Rheumatology, Pusan National University Hospital, Busan, Republic of Korea.
Young Eun
YE
Park
Division of Rheumatology, Samsung Medical Center, Seoul, Republic of Korea.
Hoon-Suk
HS
Cha
Division of Rheumatology, Seoul National University Hospital, Seoul, Republic of Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Republic of Korea.
Jin Kyun
JK
Park
Division of Rheumatology, Seoul National University Hospital, Seoul, Republic of Korea.
Eun Young
EY
Lee
Division of Rheumatology, Seoul National University Hospital, Seoul, Republic of Korea.
Eun Bong
EB
Lee
Division of Rheumatology, Seoul National University Hospital, Seoul, Republic of Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Republic of Korea.
Yeong Wook
YW
Song
D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D020381:Interleukin-17 / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D016207:Cytokines; D020381:Interleukin-17; C502936:tocilizumab