Document Detail

Changes of clinical response and bone biochemical markers in patients with ankylosing spondylitis taking etanercept.
MedLine Citation:
PMID:  17610317     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Tumor necrosis factor-alpha has a prominent role in the inflammatory process and bone resorption in patients with ankylosing spondylitis (AS). We evaluated the markers of clinical efficacy and bone biochemical changes in Korean patients with AS treated with etanercept therapy. METHODS: Serum samples from 26 patients receiving etanercept for refractory AS were obtained at baseline and 12 weeks after treatment. Clinical measures and serum levels of transforming growth factor-Beta (TGF-Beta), matrix metalloproteinase-3 (MMP-3), macrophage-colony stimulating factor (M-CSF), bone-specific alkaline phosphatase (BALP), osteocalcin, C-telopeptide (CTX), receptor activator of nuclear factor-kB ligand (RANKL), and osteoprotegerin (OPG) were measured at each timepoint. RESULTS: Significant improvement of the Bath AS Disease Activity Index (BASDAI) and Functional Index (BASFI) was achieved after 12 weeks (p < 0.001). ASsessments in Ankylosing Spondylitis Working Group (ASAS) 20 criteria were achieved by 22 patients (84.6%) after 12 weeks' treatment. ASAS 50 and 70 were achieved by 10 (38.5%) and 7 patients (26.9%). Serum levels of BALP and osteocalcin were significantly increased after 12 weeks of treatment (p < 0.05). Serum levels of CTX were not changed after treatment. Serum levels of TGF-Beta, MMP-3, and M-CSF were significantly decreased after 12 weeks of treatment (p < 0.05). Serum levels of OPG and RANKL were not changed. Change of MMP-3 had a high correlation coefficient with changes of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) upon etanercept treatment (CRP, r = 0.446, p = 0.022; ESR, r = 0.449, p = 0.021). CONCLUSION: In patients with AS, etanercept therapy may be effective for reducing disease activity and improving bone biochemical markers. MMP-3 may be a useful biomarker for monitoring etanercept therapy.
Jin-Hyun Woo; Hyun-Joo Lee; Il-Hoon Sung; Tae-Hwan Kim
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-06-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  34     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-11-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1753-9     Citation Subset:  IM    
Division of Rheumatology, the Hospital for Rheumatic Diseases, The Institute of Rheumatism, Hanyang University, Seol, Korea.
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MeSH Terms
Alkaline Phosphatase / blood
Antirheumatic Agents / therapeutic use*
Biological Markers / blood
Collagen Type I / blood
Dose-Response Relationship, Drug
Immunoglobulin G / therapeutic use*
Macrophage Colony-Stimulating Factor / blood
Matrix Metalloproteinase 3 / blood*
Middle Aged
Osteocalcin / blood*
Osteoprotegerin / blood
Peptides / blood
RANK Ligand / blood
Receptors, Tumor Necrosis Factor / therapeutic use*
Severity of Illness Index
Spondylitis, Ankylosing / blood,  drug therapy*,  physiopathology*
Transforming Growth Factor beta / blood
Reg. No./Substance:
0/Antirheumatic Agents; 0/Biological Markers; 0/Collagen Type I; 0/Immunoglobulin G; 0/Osteoprotegerin; 0/Peptides; 0/RANK Ligand; 0/Receptors, Tumor Necrosis Factor; 0/TNFSF11 protein, human; 0/Transforming Growth Factor beta; 0/collagen type I trimeric cross-linked peptide; 104982-03-8/Osteocalcin; 185243-69-0/TNFR-Fc fusion protein; 81627-83-0/Macrophage Colony-Stimulating Factor; EC Phosphatase; EC Metalloproteinase 3
Comment In:
J Rheumatol. 2007 Aug;34(8):1647-9   [PMID:  17696283 ]

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