title: Effects of Antitumor Necrosis Factor Therapy on Osteoprotegerin, Neopterin, and sRANKL Concentrations in Patients with Rheumatoid Arthritis.
abstract: BACKGROUND
  Rheumatoid arthritis is a systemic autoimmune disease characterized by joint erosions, progressive focal bone loss, and chronic inflammation.
  
  
  METHODS
  20 female patients with moderate-to-severe rheumatoid arthritis were treated with anti-TNF-antibody adalimumab in addition to concomitant antirheumatic therapies. Patients were assessed for overall disease activity using the DAS28 score, and neopterin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) concentrations as well as osteoprotegerin (OPG) and soluble receptor activator of NF-κB ligand (sRANKL) concentrations were determined before therapy and at week 12. Neopterin as well as OPG and sRANKL were determined by commercial ELISAs.
  
  
  RESULTS
  Before anti-TNF therapy patients presented with high disease activity and elevated concentrations of circulating inflammatory markers. OPG concentrations correlated with neopterin (rs = 0.494, p = 0.027), but not with DAS28. OPG concentrations and disease activity scores declined during anti-TNF-treatment (both p < 0.02). Patients who achieved remission (n = 7) or showed a good response according to EULAR criteria (n = 13) presented with initially higher baseline OPG levels, which subsequently decreased significantly during treatment (p = 0.018 for remission, p = 0.011 for good response).
  
  
  CONCLUSIONS
  Adalimumab therapy was effective in modifying disease activity and reducing proinflammatory and bone remodelling cascades.
authors.affiliation: Department of Internal Medicine VI, Innsbruck Medical University, 6020 Innsbruck, Austria ; Division of Biological Chemistry, Biocenter, Innsbruck Medical University, 6020 Innsbruck, Austria.
authors.forename: Katharina
authors.initials: K
authors.lastname: Kurz
authors.affiliation: Department of Internal Medicine VI, Innsbruck Medical University, 6020 Innsbruck, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Herold
authors.affiliation: Department of Internal Medicine VI, Innsbruck Medical University, 6020 Innsbruck, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Russe
authors.affiliation: Department of Internal Medicine VI, Innsbruck Medical University, 6020 Innsbruck, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Klotz
authors.affiliation: Department of Internal Medicine VI, Innsbruck Medical University, 6020 Innsbruck, Austria.
authors.forename: Guenter
authors.initials: G
authors.lastname: Weiss
authors.affiliation: Department of Internal Medicine VI, Innsbruck Medical University, 6020 Innsbruck, Austria ; Division of Biological Chemistry, Biocenter, Innsbruck Medical University, 6020 Innsbruck, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Fuchs
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D053244:Osteoprotegerin / Q000097:blood*; D053245:RANK Ligand / Q000097:blood*
chemical_list: D018501:Antirheumatic Agents; D053244:Osteoprotegerin; D053245:RANK Ligand; D019798:Neopterin; D000068879:Adalimumab