engleski

CYTOKINE PROFILE AND ITS INFLUENCE TO ACR INDEX IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH INFLIXIMAB

Background: During infliximab treatment in rheumatoid arthritis (RA) patients, inhibition of TNF alfa and consequently the changes in levels of other cytokines occurs. Objectives: To evaluate changes of IL-6, sTNFR and IL-10 during infliximab and methotrexate (MTX)treatment in the period of 62 weeks and correlate their values with ACR index. Methods: 24 patients with active RA despite therapy with MTX were treated with infliximab in dosage of 3 mg/kg in weeks 0, 2, 6 and then every 8 weeks until week 54. All patients were on MTX. ACR index was calculated in week 0, 6, 30 and 62. ESR, CRP, IL-6, sTNFR and IL-10 were measured in weeks 2, 4, 6, 14, 30, 54 and 62. Results: Already after the first application of infliximab levels of CRP (p=0.0004), IL-6 (p=0.000002) and sTNFR (p=0.00003) significantly reduced, and statistically significant difference was maintained until week 62. There were no statistically significant changes in values of IL-10. Comparing values of IL-6 with ACR index, non-responders were found to have levels of IL-6 significantly higher(p=0.037) than responders. However, values of sTNFR in comparison with ACR index have not shown statistically significant changes (p=0.12). Conclusion: Treatment with infliximab leads to reduction of IL-6 and sTNFR after the first application of the drug. Values of IL-6 correlate well with ACR index while values of sTNFR do not differ in responders and non-responders to infliximab.

infliximab; cytokines; disease activity

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