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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    
Abstract/OtherAbstract:
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.
Authors:
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:  -    
Affiliation:
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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