Serum cytokines and bone metabolic markers in patients with rheumatoid arthritis treated with biological disease modifying anti-rheumatic drugs
Serum cytokines and bone metabolic markers in patients with rheumatoid arthritis treated with biological disease modifying anti-rheumatic drugs
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DOI：
10.1007/s10067-022-06390-x
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发表时间：
2022-09-26
影响因子：
3.4
通讯作者：
Kaneko, Yuko
中科院分区：
文献类型：
--
作者：
Tamai, Hiroya;Nishina, Naoshi;Kaneko, Yuko
简介/目标几种生物疾病缓解抗风湿药 (bDMARD) 已广泛用于治疗类风湿性关节炎 (RA)。这些药物针对对 RA 病理生理学重要的不同分子；然而，只有少数研究比较了这些生物药物对细胞因子和骨代谢标志物的影响。本研究的主要目的是阐明不同作用方式的 bDMARD 对 RA 患者细胞因子和骨代谢标志物水平的影响。 方法 前瞻性地将英夫利昔单抗、托珠单抗或阿巴西普作为第一个 bDMARD 治疗的 RA 患者纳入本研究。纵向测量血清细胞因子和骨代谢标志物水平，并比较其水平变化。结果 共有174例患者纳入本研究，其中英夫利昔单抗组、托珠单抗组和阿巴西普组分别为55例、70例和49例患者。六个月时，尽管三种药物的临床疗效相似，但细胞因子和骨代谢标志物水平的变化却截然不同；英夫利昔单抗治疗后干扰素-γ 和肿瘤坏死因子-a 水平显着升高，托珠单抗治疗后白细胞介素 6 水平升高，阿巴西普治疗后白细胞介素 1 β 和白细胞介素 8 水平升高。与英夫利昔单抗治疗相比，托珠单抗治疗后骨特异性碱性磷酸酶和骨钙素水平升高更显着，而英夫利昔单抗治疗后骨桥蛋白和骨连接蛋白水平降低。结论不同作用方式的bDMARD对RA患者的细胞因子和骨代谢标志物水平有不同的影响。
Introduction /objectivesSeveral biological disease-modifying anti-rheumatic drugs (bDMARDs) have been widely used for the management of rheumatoid arthritis (RA). These drugs target different molecules important for the pathophysiology of RA; however, only a few studies have compared the effects of these biological drugs on cytokines and bone metabolic markers. The main aim of this study is to clarify the effects of bDMARDs with different modes of action on the cytokine and bone metabolic marker levels in patients with RA.Methods Patients with RA who were initiated on infliximab, tocilizumab, or abatacept as the first bDMARD were prospectively enrolled in this study. Serum cytokine and bone metabolic marker levels were measured longitudinally, and changes in their levels were compared.Results A total of 174 patients were enrolled in this study, with 55, 70, and 49 patients in the infliximab, tocilizumab, and abatacept groups, respectively. At six months, despite the similar clinical effectiveness of the three drugs, changes in the cytokine and bone metabolic marker levels were distinct; interferon-gamma and tumor necrosis factor-a levels were significantly increased with infliximab, interleukin-6 levels were increased with tocilizumab, and interleukin-1 beta and interleukin-8 levels were increased with abatacept treatment. Bone-specific alkaline phosphatase and osteocalcin levels increased more significantly with tocilizumab than with infliximab, while osteopontin and osteonectin levels decreased with infliximab treatment.Conclusions bDMARDs with different modes of action exert different effects on the cytokine and bone metabolic marker levels in patients with RA.