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Etanercept Concentration in Patients with Rheumatoid Arthritis and Its Potential Influence on Treatment Decisions: A Pilot Study.
MedLine Citation:
PMID:  22753654     Owner:  NLM     Status:  Publisher    
OBJECTIVE: For patients with rheumatoid arthritis (RA), recommendations are inconclusive about whether tumor necrosis factor-a (TNF-a)-blocker therapy should be evaluated at 3 or 6 months. Biomarkers are needed to predict at 3 months which patients would benefit from further treatment because of nonoptimal response. Our objective was to investigate whether serum etanercept (ETN) concentrations and anti-ETN antibodies at 3 months are predictors of clinical response to ETN at 6 months in patients with RA in terms of European League Against Rheumatism criteria and Disease Activity Score in 28 joints (DAS28). METHODS: Between 2009 and 2010, we included 19 women with active RA who were candidates for ETN therapy. Response criteria were evaluated at 3 and 6 months. Serum concentrations of ETN and anti-ETN antibodies were measured by ELISA at baseline and at 3 and 6 months. RESULTS: Eighteen patients completed followup. Three-month ETN concentrations were lower for 6- month nonresponders than responders (p = 0.03). Three-month ETN levels correlated significantly with change in DAS28 between baseline and 6 months (r = -0.62, p = 0.006). The best predictor of response at 6 months was observed with an ETN threshold of 3.1 μg/ml at 3 months. No anti-ETN antibodies were found. CONCLUSION: ETN concentrations at 3 months predict response to ETN therapy at 6 months. Low ETN concentrations could explain the absence of response to ETN, suggesting that patients with low ETN levels could benefit from increased ETN dose or earlier interruption of treatment.
Claire Immediato Daïen; Vincent Daïen; Ermis Parussini; Anne-Marie Dupuy; Bernard Combe; Jacques Morel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-1
Journal Detail:
Title:  The Journal of rheumatology     Volume:  -     ISSN:  0315-162X     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the Department of Rheumatology and Department of Biochemistry, Teaching Hospital of Lapeyronie and Montpellier I University, Montpellier; Biology of TNF Family Members, Molecular Genetic Institute of Montpellier (IGMM), UMR5535, CNRS, Montpellier; Inserm Unité 1061, Recherche Épidémiologique et Clinique, Montpellier; and Biomedical Diagnostics, Marne la Vallee, France.
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