Limits...
MRP8/14 serum levels as a predictor of response to starting and stopping anti-TNF treatment in juvenile idiopathic arthritis.

Anink J, Van Suijlekom-Smit LW, Otten MH, Prince FH, van Rossum MA, Dolman KM, Hoppenreijs EP, ten Cate R, Ursu S, Wedderburn LR, Horneff G, Frosch M, Vogl T, Gohar F, Foell D, Roth J, Holzinger D - Arthritis Res. Ther. (2015)

Bottom Line: Levels decreased after start of treatment only in responders (p < 0.001).Patients who flared within 6 months after treatment discontinuation had higher MRP8/14 levels (p = 0.031, median 1025 ng/ml (IQR 588-1288)) compared to patients with stable remission (505 ng/ml (IQR 346-778)).High levels of baseline MRP8/14 are associated with good response to anti-TNF treatment, whereas elevated MRP8/14 levels at discontinuation of etanercept are associated with higher chance to flare.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics/ Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands. j.anink@erasmusmc.nl.

ABSTRACT

Introduction: Approximately 30% of juvenile idiopathic arthritis (JIA) patients fail to respond to anti-TNF treatment. When clinical remission is induced, some patients relapse after treatment has been stopped. We tested the predictive value of MRP8/14 serum levels to identify responders to treatment and relapse after discontinuation of therapy.

Methods: Samples from 88 non-systemic JIA patients who started and 26 patients who discontinued TNF-blockers were analyzed. MRP8/14 serum levels were measured by in-house MRP8/14 ELISA and by Bühlmann Calprotectin ELISA at start of anti-TNF treatment, within 6 months after start and at discontinuation of etanercept in clinical remission. Patients were categorized into responders (ACRpedi ≥ 50 and/or inactive disease) and non-responders (ACRpedi < 50) within six months after start, response was evaluated by change in JADAS-10. Disease activity was assessed within six months after discontinuation.

Results: Baseline MRP8/14 levels were higher in responders (median MRP8/14 of 1466 ng/ml (IQR 1045-3170)) compared to non-responders (median MRP8/14 of 812 (IQR 570-1178), p < 0.001). Levels decreased after start of treatment only in responders (p < 0.001). Change in JADAS-10 was correlated with baseline MRP8/14 levels (Spearman's rho 0.361, p = 0.001). Patients who flared within 6 months after treatment discontinuation had higher MRP8/14 levels (p = 0.031, median 1025 ng/ml (IQR 588-1288)) compared to patients with stable remission (505 ng/ml (IQR 346-778)). Results were confirmed by Bühlmann ELISA with high reproducibility but different overall levels.

Conclusion: High levels of baseline MRP8/14 are associated with good response to anti-TNF treatment, whereas elevated MRP8/14 levels at discontinuation of etanercept are associated with higher chance to flare.

No MeSH data available.


Related in: MedlinePlus

Differences in myeloid related protein (MRP)8/14 at time of medication discontinuation between patients who then had persistent remission and patients who had flares
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4528380&req=5

Fig3: Differences in myeloid related protein (MRP)8/14 at time of medication discontinuation between patients who then had persistent remission and patients who had flares

Mentions: Patients who had flares within 6 months (n = 12) after discontinuation of etanercept had higher MRP levels at discontinuation than patients who did not have flares (n = 14) (p = 0.031, median 1,025 ng/ml (IQR 588–1288) vs 505 ng/ml (IQR 346–778) (Fig. 3)). Patients discontinuing medication were allowed to have a PGA between 0 and 10 mm. Of the 26 patients discontinuing treatment, 14 patients had a PGA >0 (median PGA of 3). MRP levels were comparable between the patients who had a PGA of 0 and patients who had a PGA >0 at discontinuation of treatment (p = 0.432). Full disease activity parameters for all patients at discontinuation can be found in Additional file 1, Table S2.Fig. 3


MRP8/14 serum levels as a predictor of response to starting and stopping anti-TNF treatment in juvenile idiopathic arthritis.

Anink J, Van Suijlekom-Smit LW, Otten MH, Prince FH, van Rossum MA, Dolman KM, Hoppenreijs EP, ten Cate R, Ursu S, Wedderburn LR, Horneff G, Frosch M, Vogl T, Gohar F, Foell D, Roth J, Holzinger D - Arthritis Res. Ther. (2015)

Differences in myeloid related protein (MRP)8/14 at time of medication discontinuation between patients who then had persistent remission and patients who had flares
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4528380&req=5

Fig3: Differences in myeloid related protein (MRP)8/14 at time of medication discontinuation between patients who then had persistent remission and patients who had flares
Mentions: Patients who had flares within 6 months (n = 12) after discontinuation of etanercept had higher MRP levels at discontinuation than patients who did not have flares (n = 14) (p = 0.031, median 1,025 ng/ml (IQR 588–1288) vs 505 ng/ml (IQR 346–778) (Fig. 3)). Patients discontinuing medication were allowed to have a PGA between 0 and 10 mm. Of the 26 patients discontinuing treatment, 14 patients had a PGA >0 (median PGA of 3). MRP levels were comparable between the patients who had a PGA of 0 and patients who had a PGA >0 at discontinuation of treatment (p = 0.432). Full disease activity parameters for all patients at discontinuation can be found in Additional file 1, Table S2.Fig. 3

Bottom Line: Levels decreased after start of treatment only in responders (p < 0.001).Patients who flared within 6 months after treatment discontinuation had higher MRP8/14 levels (p = 0.031, median 1025 ng/ml (IQR 588-1288)) compared to patients with stable remission (505 ng/ml (IQR 346-778)).High levels of baseline MRP8/14 are associated with good response to anti-TNF treatment, whereas elevated MRP8/14 levels at discontinuation of etanercept are associated with higher chance to flare.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics/ Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands. j.anink@erasmusmc.nl.

ABSTRACT

Introduction: Approximately 30% of juvenile idiopathic arthritis (JIA) patients fail to respond to anti-TNF treatment. When clinical remission is induced, some patients relapse after treatment has been stopped. We tested the predictive value of MRP8/14 serum levels to identify responders to treatment and relapse after discontinuation of therapy.

Methods: Samples from 88 non-systemic JIA patients who started and 26 patients who discontinued TNF-blockers were analyzed. MRP8/14 serum levels were measured by in-house MRP8/14 ELISA and by Bühlmann Calprotectin ELISA at start of anti-TNF treatment, within 6 months after start and at discontinuation of etanercept in clinical remission. Patients were categorized into responders (ACRpedi ≥ 50 and/or inactive disease) and non-responders (ACRpedi < 50) within six months after start, response was evaluated by change in JADAS-10. Disease activity was assessed within six months after discontinuation.

Results: Baseline MRP8/14 levels were higher in responders (median MRP8/14 of 1466 ng/ml (IQR 1045-3170)) compared to non-responders (median MRP8/14 of 812 (IQR 570-1178), p < 0.001). Levels decreased after start of treatment only in responders (p < 0.001). Change in JADAS-10 was correlated with baseline MRP8/14 levels (Spearman's rho 0.361, p = 0.001). Patients who flared within 6 months after treatment discontinuation had higher MRP8/14 levels (p = 0.031, median 1025 ng/ml (IQR 588-1288)) compared to patients with stable remission (505 ng/ml (IQR 346-778)). Results were confirmed by Bühlmann ELISA with high reproducibility but different overall levels.

Conclusion: High levels of baseline MRP8/14 are associated with good response to anti-TNF treatment, whereas elevated MRP8/14 levels at discontinuation of etanercept are associated with higher chance to flare.

No MeSH data available.


Related in: MedlinePlus