title: Methotrexate Reduced TNF Bioactivity in Rheumatoid Arthritis Patients Treated with Infliximab.
abstract: Objectives.To evaluate methotrexate effect on tumor necrosis factor (TNF) alpha bioactivity during infliximab (IFX) therapy in rheumatoid arthritis (RA) patients and to correlate TNF bioactivity with antibody towards IFX (ATI) development and RA clinical response.Materials and Methods.Thirty-nine active women RA patients despite conventional synthetic disease modifying antirheumatic drugs (csDMARDs) requiring IFX therapy were enrolled, and clinical data and blood samples were recorded at baseline (W0) and at 6 weeks (W6), W22, and W54 of IFX treatment. TNF bioactivity as well as IFX trough and ATI concentrations were assessed on blood samples.Results.TNF bioactivity decreased from W0 to W54 with a large range from W22 at the time of ATI detection. From W22, TNF bioactivity was lower in presence of methotrexate as csDMARD compared to other csDMARDs. IFX trough concentration increased from W0 to W54 with a large range from W22, similarly to TNF bioactivity. Methotrexate therapy prevented ATI presence at W22 and reduced TNF bioactivity compared to other csDMARDs (p= 0.002).Conclusion.This suggests that methotrexate plays a key role in TNF bioactivity and against ATI development.
authors.affiliation: Department of Rheumatology, CHU Saint-Etienne, Saint-Etienne, France.
authors.forename: Delphine
authors.identifier: 0000-0001-8729-3413
authors.initials: D
authors.lastname: Dénarié
authors.affiliation: Immunology and Immunomonitoring Department, CHU de Saint-Etienne, Saint-Etienne, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Rinaudo-Gaujous
authors.affiliation: Department of Rheumatology, CHU Saint-Etienne, Saint-Etienne, France; INSERM 1059/SAINBIOSE, Université Jean Monet, Université de Lyon, Saint-Etienne, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Thomas
authors.affiliation: Immunology and Immunomonitoring Department, CHU de Saint-Etienne, Saint-Etienne, France.
authors.forename: Stéphane
authors.identifier: 0000-0002-8830-4273
authors.initials: S
authors.lastname: Paul
authors.affiliation: Department of Rheumatology, CHU Saint-Etienne, Saint-Etienne, France; INSERM 1059/SAINBIOSE, Université Jean Monet, Université de Lyon, Saint-Etienne, France.
authors.forename: Hubert
authors.identifier: 0000-0003-1177-9497
authors.initials: H
authors.lastname: Marotte
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D001681:Biological Assay; D015331:Cohort Studies; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000378:metabolism*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D008727:Methotrexate