Athan Baillet1, Laure Gossec2, Simon Paternotte3, Adrien Etcheto3, Bernard Combe4, Olivier Meyer5, Xavier Mariette6, Jacques-Eric Gottenberg7, Maxime Dougados3. 1. GREPI UJF CNRS, Grenoble, France. 2. UPMC Université Paris 06, GRC-UPMC 08 (EEMOIS), Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Paris, France. 3. Paris-Descartes University, Assistance Publique Hôpitaux de Paris, Cochin Hospital, Paris, France. 4. Lapeyronie University Hospital, Montpellier I University, Montpellier, France. 5. Université Paris 7 Denis Diderot, UFR de Médecine, and Assistance Publique Hôpitaux de Paris, Hôpital Bichat, Paris, France. 6. Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Institut Pour la Santé et la Recherche Médicale Paris, France. 7. Strasbourg University Hospital, Strasbourg, France.
Abstract
OBJECTIVE: Interleukin-6 (IL-6) is a key cytokine in rheumatoid arthritis pathogenesis. We aimed to analyze the association between IL-6 serum levels and joint inflammation at baseline and the correlation of time-integrated IL-6 values with structural damage during the first 36 months of early arthritis. METHODS: IL-6 was assessed by 2 different methods in 813 patients of the French early arthritis cohort ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) over 36 months. IL-6 and C-reactive protein (CRP) changes were correlated to radiographic progression assessed by the total Sharp/van der Heijde score (SHS). Synovium inflammation was assessed in a subgroup of 126 patients by ultrasonography (US). The relationship between SHS change and IL-6 or CRP levels at baseline was investigated by a univariate regression and a multivariable analysis. A longitudinal model nested by visit and patient was conducted to assess the role of IL-6 on SHS at each visit. RESULTS: At baseline, IL-6 was more strongly correlated with the swollen joint count than CRP level. In the univariate analysis, the time-integrated value of IL-6 was more strongly correlated with the swollen joint count and the variation of SHS than time-integrated CRP level. Baseline IL-6 was not independently associated with SHS change. Longitudinal models nested by patient showed that IL-6 levels were associated with structural damage independently from the Disease Activity Score in 28 joints, smoking status, rheumatoid factor, and anti-citrullinated protein peptide antibody serology, treatments, and CRP levels. CONCLUSION: IL-6 level was a marker of US synovitis at baseline. Repeated measurements of IL-6 are associated with structural damage.
OBJECTIVE:Interleukin-6 (IL-6) is a key cytokine in rheumatoid arthritis pathogenesis. We aimed to analyze the association between IL-6 serum levels and joint inflammation at baseline and the correlation of time-integrated IL-6 values with structural damage during the first 36 months of early arthritis. METHODS:IL-6 was assessed by 2 different methods in 813 patients of the French early arthritis cohort ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) over 36 months. IL-6 and C-reactive protein (CRP) changes were correlated to radiographic progression assessed by the total Sharp/van der Heijde score (SHS). Synovium inflammation was assessed in a subgroup of 126 patients by ultrasonography (US). The relationship between SHS change and IL-6 or CRP levels at baseline was investigated by a univariate regression and a multivariable analysis. A longitudinal model nested by visit and patient was conducted to assess the role of IL-6 on SHS at each visit. RESULTS: At baseline, IL-6 was more strongly correlated with the swollen joint count than CRP level. In the univariate analysis, the time-integrated value of IL-6 was more strongly correlated with the swollen joint count and the variation of SHS than time-integrated CRP level. Baseline IL-6 was not independently associated with SHS change. Longitudinal models nested by patient showed that IL-6 levels were associated with structural damage independently from the Disease Activity Score in 28 joints, smoking status, rheumatoid factor, and anti-citrullinated protein peptide antibody serology, treatments, and CRP levels. CONCLUSION:IL-6 level was a marker of US synovitis at baseline. Repeated measurements of IL-6 are associated with structural damage.
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