Internal Med Medical News about Methotrexate therapy;active rheumatoid arthritis;Golimumab

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E-selectin, interleukin 18, serum amyloid A, and matrix metalloproteinase 9 are associated with clinical response to golimumab plus methotrexate in patients with active rheumatoid arthritis despite methotrexate therapy
Journal of Rheumatology, 07/02/09

Visvanathan S et al. – Study demonstrates that treatment with golimumab (human monoclonal antibody to TNF-α) + methotrexate (MTX) therapy in patients with active rheumatoid arthritis (RA) significantly decreased several inflammatory biomarkers. Decreases in serum levels of serum amyloid A (SAA), E-selectin, and MMP-9 at wk 4 may be useful in predicting clinical response at wk 16.

Methods

Main objectives of this study were to:
- Assess the effect of golimumab + MTX on selected inflammatory biomarkers and
- Determine if these effects predict clinical response in RA
Sera from adults with active RA despite MTX therapy, who received:
- Subcutaneous injections of placebo + MTX (n=34) or
- Golimumab 50 or 100 mg every 2 or 4 wks + MTX (n=137)
  were analyzed for levels of CRP, SAA, IL-18, E-selectin, MMP-9 and TIMP-1

Results

Golimumab + MTX treatment decreased serum CRP, SAA, IL-18, E-selectin, TIMP-1, and MMP-9 levels vs MTX
This difference was noted first at wk 4; decreases were sustained through wk 16
Larger magnitudes of decrease in all biomarkers were observed for clinical responders vs nonresponders
Reductions in levels of SAA, E-selectin, MMP-9 at wk 4 correlated with improvement in swollen joint count (SJC) at wk 16
Same was true for reductions in E-selectin with improvement in tender joint count at wk 16
After accounting for the biomarkers, however, treatment group was no longer significant for SJC

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