title: Interleukin-23 in early disease development in rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate the levels of interleukin (IL)-23 in patients with early rheumatoid arthritis (eRA) and the effect of anti-tumour necrosis factor (anti-TNF)-α treatment on IL-23 levels.
  
  
  METHODS
  Treatment-naïve eRA patients from the OPERA cohort were included (n = 151). Patients were randomized to methotrexate (MTX) plus adalimumab (ADA; n = 75) or MTX plus placebo-ADA (PLA; n = 76). Plasma samples were obtained at baseline and at months 3, 6, and 12 together with values for C-reactive protein (CRP), the 28-joint Disease Activity Score based on CRP (DAS28CRP), scores on the Clinical Disease Activity Index (CDAI) and the Simplified Disease Activity Index (SDAI), visual analogue scale (VAS) for pain/fatigue/physician global and total Sharp/van der Heijde score (TSS). IL-23 was measured at each time point.
  
  
  RESULTS
  IL-23 levels decreased significantly in the ADA group from 20.6 pg/mL (IQR 13.1-32.7 pg/mL) at baseline to 18 pg/mL (IQR 7.2-25.0 pg/mL) at 12 months (p < 0.01). No significant decrease in IL-23 level was observed in the PLA group. No associations between baseline IL-23 levels and measures of disease activity (DAS28CRP, CRP, CDAI, or SDAI) at 12 or 24 months were present in the treatment groups. Baseline IL-23 correlated inversely with changes in TSS and symptom duration before diagnosis.
  
  
  CONCLUSIONS
  Our data show increased baseline levels and a significant decrease in IL-23 levels in eRA patients treated with anti-TNF-α. The inverse correlation with duration of symptoms before diagnosis supports the importance of IL-23 in the preclinical disease development of RA.
authors.forename: T
authors.initials: T
authors.lastname: Andersen
authors.forename: M
authors.initials: M
authors.lastname: Hvid
authors.forename: C
authors.initials: C
authors.lastname: Johansen
authors.forename: K
authors.initials: K
authors.lastname: Stengaard-Pedersen
authors.forename: M L
authors.initials: ML
authors.lastname: Hetland
authors.forename: K
authors.initials: K
authors.lastname: Hørslev-Petersen
authors.forename: P
authors.initials: P
authors.lastname: Junker
authors.forename: M
authors.initials: M
authors.lastname: Østergaard
authors.forename: B
authors.initials: B
authors.lastname: Deleuran
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D053759:Interleukin-23 / Q000097:blood*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D015415:Biomarkers; D053759:Interleukin-23; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000068879:Adalimumab; D008727:Methotrexate