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Radiographic progression is associated with resolution of systemic inflammation in patients with axial spondylarthritis treated with tumor necrosis factor α inhibitors: a study of radiographic progression, inflammation on magnetic resonance imaging, and circulating biomarkers of inflammation, angiogenesis, and cartilage and bone turnover.
- Source :
-
Arthritis and rheumatism [Arthritis Rheum] 2011 Dec; Vol. 63 (12), pp. 3789-800. - Publication Year :
- 2011
-
Abstract
- Objective: To investigate the relationship of circulating biomarkers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6], and YKL-40), angiogenesis (vascular endothelial growth factor), cartilage turnover (C-terminal crosslinking telopeptide of type II collagen [CTX-II], total aggrecan, matrix metalloproteinase 3 [MMP-3], and cartilage oligomeric matrix protein [COMP]), and bone turnover (CTX-I and osteocalcin) to inflammation on magnetic resonance imaging (MRI) and radiographic progression in patients with axial spondylarthritis (SpA) beginning tumor necrosis factor α (TNFα) inhibitor therapy.<br />Methods: MRIs were evaluated according to the Berlin sacroiliac (SI) joint and spine inflammation scoring method at baseline, week 22, and week 46. Radiographs were evaluated using the modified Stoke Ankylosing Spondylitis Spine Score at baseline and week 46. Patients with new syndesmophytes were identified. Biomarker levels in patients were compared to levels in healthy subjects.<br />Results: Higher pretreatment MRI inflammation scores for SI joints and/or lumbar spine were associated with higher baseline CTX-II levels, but not with higher levels of biomarkers of inflammation and bone turnover. During treatment with TNFα inhibitors, a decrease in MRI inflammation scores from baseline to week 22 was associated with larger percentage decreases in and a normalization of CRP and IL-6 levels as compared to an increase or no change in MRI scores. Development of new syndesmophytes was associated with larger percentage decreases in CRP and IL-6 levels and an increase in osteocalcin level, and with normalization of CRP and IL-6 levels from baseline to week 22. Persistent systemic inflammation was associated with radiographic nonprogression.<br />Conclusion: Our findings indicate that inflammation on baseline MRI is associated with higher CTX-II levels. Radiographic progression is associated with decreased systemic inflammation, as assessed by IL-6 and CRP levels and MRI, supporting the notion of a link between the resolution of inflammation and new bone formation in SpA patients during anti-TNFα therapy.<br /> (Copyright © 2011 by the American College of Rheumatology.)
- Subjects :
- Adalimumab
Adult
Antibodies, Monoclonal therapeutic use
Antibodies, Monoclonal, Humanized therapeutic use
Biomarkers blood
C-Reactive Protein metabolism
Cartilage Oligomeric Matrix Protein
Case-Control Studies
Cohort Studies
Extracellular Matrix Proteins blood
Female
Glycoproteins blood
Humans
Infliximab
Interleukin-6 blood
Magnetic Resonance Imaging
Male
Matrilin Proteins
Matrix Metalloproteinase 3 blood
Middle Aged
Osteocalcin blood
Prospective Studies
Radiography
Spondylarthritis blood
Vascular Endothelial Growth Factor A blood
Bone and Bones metabolism
Cartilage metabolism
Disease Progression
Inflammation diagnostic imaging
Inflammation pathology
Neovascularization, Pathologic blood
Spondylarthritis drug therapy
Tumor Necrosis Factor-alpha antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1529-0131
- Volume :
- 63
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Arthritis and rheumatism
- Publication Type :
- Academic Journal
- Accession number :
- 22127697
- Full Text :
- https://doi.org/10.1002/art.30627