OBJECTIVES: Treatment with anti-TNF agents is well established in psoriatic arthritis (PsA). Anti-TNF agents are capable of modulating complement activity in vitro but there are no data on the in vivo effect. Anti-TNF have high costs and potential risks, thus, there is an urgent need for accurate predictors of response. We aimed at studying the usefulness of erythrocyte-sedimentation-rate (ESR), C-reactive protein (CRP), and complement for response prediction and monitoring of anti-TNF treatment in PsA patients. METHODS: Fifty-five patients were included consecutively before starting etanercept or adalimumab. ESR, CRP, plasma complement C3, C4, and C3 and B cleavage fragments were evaluated at baseline and after 22 weeks of anti-TNF treatment. Disease activity was measured with DAS28 and response to therapy with EULAR criteria. Complement was evaluated at baseline in 30 healthy subjects as well. RESULTS: At baseline, C3 and C4 levels were significantly higher than in controls (C3 126.9±22 vs. 110±25 mg/dl, p=0.000002; C4 31.2±9.2 vs. 22.7±8.3 mg/dl, p=0.0003). After anti-TNF therapy, C3 and C4 levels were significantly reduced to normalization (p=0.0009 and 0.0005, respectively) and ESR, CRP and DAS28 showed a significant reduction (p=0.002, 0.004 and 0.0001, respectively). Split products of C3 and B were not observed at baseline and after 22 weeks. Higher baseline C3 levels were associated with EULAR non-response (p=0.011). CONCLUSIONS: PsA patients with moderate to severe disease show elevated C3 and C4 levels, reverted by anti-TNF treatment. High C3 may be considered a hallmark of inflammation and C3 revealed the highest predictive value for response to anti-TNF.

Chimenti, M.S., Perricone, C., Graceffa, D., Di Muzio, G., Ballanti, E., Guarino, M., et al. (2012). Complement system in psoriatic arthritis: a useful marker in response prediction and monitoring of anti-TNF treatment. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 30(1), 23-30.

Complement system in psoriatic arthritis: a useful marker in response prediction and monitoring of anti-TNF treatment.

CHIMENTI, MARIA SOLE;PERRICONE, CHIARA;GRACEFFA , DARIO;DI MUZIO, GIOIA;BALLANTI, ELEONORA;GUARINO, MARIA DOMENICA;CONIGLIARO, PAOLA;GRECO, ELISABETTA;PERRICONE, ROBERTO
2012-01

Abstract

OBJECTIVES: Treatment with anti-TNF agents is well established in psoriatic arthritis (PsA). Anti-TNF agents are capable of modulating complement activity in vitro but there are no data on the in vivo effect. Anti-TNF have high costs and potential risks, thus, there is an urgent need for accurate predictors of response. We aimed at studying the usefulness of erythrocyte-sedimentation-rate (ESR), C-reactive protein (CRP), and complement for response prediction and monitoring of anti-TNF treatment in PsA patients. METHODS: Fifty-five patients were included consecutively before starting etanercept or adalimumab. ESR, CRP, plasma complement C3, C4, and C3 and B cleavage fragments were evaluated at baseline and after 22 weeks of anti-TNF treatment. Disease activity was measured with DAS28 and response to therapy with EULAR criteria. Complement was evaluated at baseline in 30 healthy subjects as well. RESULTS: At baseline, C3 and C4 levels were significantly higher than in controls (C3 126.9±22 vs. 110±25 mg/dl, p=0.000002; C4 31.2±9.2 vs. 22.7±8.3 mg/dl, p=0.0003). After anti-TNF therapy, C3 and C4 levels were significantly reduced to normalization (p=0.0009 and 0.0005, respectively) and ESR, CRP and DAS28 showed a significant reduction (p=0.002, 0.004 and 0.0001, respectively). Split products of C3 and B were not observed at baseline and after 22 weeks. Higher baseline C3 levels were associated with EULAR non-response (p=0.011). CONCLUSIONS: PsA patients with moderate to severe disease show elevated C3 and C4 levels, reverted by anti-TNF treatment. High C3 may be considered a hallmark of inflammation and C3 revealed the highest predictive value for response to anti-TNF.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/16 - Reumatologia
English
Con Impact Factor ISI
Chimenti, M.S., Perricone, C., Graceffa, D., Di Muzio, G., Ballanti, E., Guarino, M., et al. (2012). Complement system in psoriatic arthritis: a useful marker in response prediction and monitoring of anti-TNF treatment. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 30(1), 23-30.
Chimenti, Ms; Perricone, C; Graceffa, D; DI MUZIO, G; Ballanti, E; Guarino, Md; Conigliaro, P; Greco, E; Kroegler, B; Perricone, R
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/56689
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