Early Prognostic Factors Associated with the Efficacy of Infliximab Treatment for Patients with Rheumatoid Arthritis with Inadequate Response to Methotrexate

Satoko Hayashi, Katsuya Suzuki, Keiko Yoshimoto, Masaru Takeshita, Takahiko Kurasawa, Kunihiro Yamaoka, Tsutomu Takeuchi

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Introduction: Early prognostic factors for the clinical response in patients with rheumatoid arthritis (RA) after 1 year of treatment with infliximab (IFX) as part of routine clinical practice were investigated. Methods: Thirty-five patients with RA with an inadequate response to methotrexate were enrolled and administered IFX (3–9 mg/kg, every 4–8 weeks). Serum trough levels of IFX and levels of 9 cytokines were measured at baseline and at 3, 6 months, and 1 year. Associations between these parameters and clinical indicators were statistically analyzed. Results: Serum trough levels of IFX and serum levels of interleukin (IL)-6 in the early phase of IFX treatment were investigated. Patients with low serum IL-6 achieved a higher clinical response as evaluated by the European League Against Rheumatism response criteria. Notably, the serum levels of IL-6 and IL-10 at baseline exhibited a significant positive correlation with disease activity at 1 year. Low serum levels of IL-6 and IL-10 at baseline were associated with low Disease Activity Score 28 erythrocyte sedimentation rate (DAS28-ESR). Cut-off values of IL-6 (5.45 pg/mL) and IL-10 and (1.68 pg/mL) enabled discrimination of DAS28-ESR remission from non-remission with high sensitivity and moderate specificity. Conclusion: Following the initiation of IFX treatment, early disease activity and remission were associated with serum levels of IL-6. Serum levels of IL-6 and IL-10 at baseline predict the efficacy after 1 year of treatment with IFX. Patients with high serum levels of IL-6 and IL-10 at baseline before IFX treatment might require more intensive therapy to achieve higher rates of clinical remission at 1 year. Funding: Eisai Co., Ltd.

Original languageEnglish
Pages (from-to)155-166
Number of pages12
JournalRheumatology and Therapy
Volume3
Issue number1
DOIs
Publication statusPublished - 2016 Jun

Keywords

  • Clinical efficacy
  • Infliximab
  • Interleukin-6
  • Prognostic serum marker
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy

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