Pradeepta Sekhar Patro1, Ankita Singh1, Ramnath Misra1, Amita Aggarwal2. 1. From the Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.P.S. Patro, DM Senior Resident, MD Internal Medicine, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences; A. Singh, PhD Student, MSc Biotechnology, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences; R. Misra, Professor, FRCP, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences; A. Aggarwal, Professor, DM Clinical Immunology, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. 2. From the Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.P.S. Patro, DM Senior Resident, MD Internal Medicine, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences; A. Singh, PhD Student, MSc Biotechnology, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences; R. Misra, Professor, FRCP, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences; A. Aggarwal, Professor, DM Clinical Immunology, Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. aa.amita@gmail.com amita@sgpgi.ac.in.
Abstract
OBJECTIVE: Myeloid-related proteins (MRP) 8/14 belong to a family of calcium-binding proteins produced by myeloid cells. Baseline serum levels of MRP8/14 have been shown to predict response to biologicals in rheumatoid arthritis (RA). Because methotrexate (MTX) is the first-line therapy in RA, we studied whether MRP8/14 levels can predict response to MTX. METHODS: Patients with active RA disease who were naive to disease-modifying antirheumatic drugs were enrolled. All patients were treated with MTX only, to a maximum of 25 mg/week or the maximal tolerated dose. At 4 months, the European League Against Rheumatism response was assessed. All patients who needed rescue therapy after 2 months or who did not respond at 4 months were classified as nonresponders. RESULTS: Ninety patients were enrolled, of whom 3 discontinued MTX within 4-6 weeks, so 87 patients were analyzed [74 women, median (interquartile range; IQR) for the Disease Activity Score at 28 joints (DAS28) was 4.43 (4.1-5.1)]. The median (IQR) serum MRP8/14 level at baseline was 19.95 µg/ml (11.49-39.06). The serum MRP8/14 had good correlation with DAS28-C-reactive protein (CRP; r = 0.35, p = 0.001). The MRP8/14 levels fell significantly after 4 months of treatment (10.28 µg/ml, 5.95-16.05, p < 0.001). Among 87 patients, 69 were responders. The median (IQR) baseline level of MRP8/14 was higher among responders compared with nonresponders: 23.99 µg/ml (15.39-42.75) versus 9.58 µg/ml (6.11-24.93, p = 0.00250). The levels declined in the responders, from 23.99 µg/ml (15.39-42.75) to 10.41 µg/ml (5.83-15.61, p < 0.001), but not in the nonresponders, from 9.58 µg/ml (6.11-24.93) to 9.19 µg/ml (7.74-21.96, p = 0.687). Receiver-operation characteristic analysis showed that MRP8/14 was a better predictor of response than CRP and erythrocyte sedimentation rate, especially with early disease onset (< 1-yr duration). CONCLUSION: MRP8/14 is a good marker of disease activity in RA, and higher levels predict response to MTX.
OBJECTIVE: Myeloid-related proteins (MRP) 8/14 belong to a family of calcium-binding proteins produced by myeloid cells. Baseline serum levels of MRP8/14 have been shown to predict response to biologicals in rheumatoid arthritis (RA). Because methotrexate (MTX) is the first-line therapy in RA, we studied whether MRP8/14 levels can predict response to MTX. METHODS:Patients with active RA disease who were naive to disease-modifying antirheumatic drugs were enrolled. All patients were treated with MTX only, to a maximum of 25 mg/week or the maximal tolerated dose. At 4 months, the European League Against Rheumatism response was assessed. All patients who needed rescue therapy after 2 months or who did not respond at 4 months were classified as nonresponders. RESULTS: Ninety patients were enrolled, of whom 3 discontinued MTX within 4-6 weeks, so 87 patients were analyzed [74 women, median (interquartile range; IQR) for the Disease Activity Score at 28 joints (DAS28) was 4.43 (4.1-5.1)]. The median (IQR) serum MRP8/14 level at baseline was 19.95 µg/ml (11.49-39.06). The serum MRP8/14 had good correlation with DAS28-C-reactive protein (CRP; r = 0.35, p = 0.001). The MRP8/14 levels fell significantly after 4 months of treatment (10.28 µg/ml, 5.95-16.05, p < 0.001). Among 87 patients, 69 were responders. The median (IQR) baseline level of MRP8/14 was higher among responders compared with nonresponders: 23.99 µg/ml (15.39-42.75) versus 9.58 µg/ml (6.11-24.93, p = 0.00250). The levels declined in the responders, from 23.99 µg/ml (15.39-42.75) to 10.41 µg/ml (5.83-15.61, p < 0.001), but not in the nonresponders, from 9.58 µg/ml (6.11-24.93) to 9.19 µg/ml (7.74-21.96, p = 0.687). Receiver-operation characteristic analysis showed that MRP8/14 was a better predictor of response than CRP and erythrocyte sedimentation rate, especially with early disease onset (< 1-yr duration). CONCLUSION:MRP8/14 is a good marker of disease activity in RA, and higher levels predict response to MTX.
Entities:
Keywords:
BIOMARKER; DRUG RESPONSE; INFLAMMATORY ARTHRITIS; METHOTREXATE; MRP8/14; RHEUMATOID ARTHRITIS
Authors: Katie Bechman; Lieke Tweehuysen; Toby Garrood; David L Scott; Andrew P Cope; James B Galloway; Margaret H Y Ma Journal: J Rheumatol Date: 2018-09-01 Impact factor: 4.666
Authors: Irene Di Ceglie; Peter L E M van Lent; Edwin J W Geven; Marije I Koenders; Arjen B Blom; Thomas Vogl; Johannes Roth; Martijn H J van den Bosch Journal: Arthritis Res Ther Date: 2021-08-19 Impact factor: 5.156
Authors: Lieke Tweehuysen; Nathan den Broeder; Noortje van Herwaarden; Leo A B Joosten; Peter L van Lent; Thomas Vogl; Frank H J van den Hoogen; Rogier M Thurlings; Alfons A den Broeder Journal: RMD Open Date: 2018-04-09