Soluble Biomarkers Associated with Response to Treatment with Tumor Necrosis Factor Inhibitors in Psoriatic Arthritis

• Published in: Journal of rheumatology Vol. 40; no. 6; pp. 866 - 871
• Main Authors: CHANDRAN, Vinod, SHEN, Hua, POLLOCK, Remy A, PELLETT, Fawnda J, CARTY, Adele, COOK, Richard J, GLADMAN, Dafna D
• Format: Journal Article
• Language: English
• Published: Toronto, ON Journal of Rheumatology Publishing 01-06-2013
• Subjects: Adalimumab; Adult; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis, Psoriatic - blood; Arthritis, Psoriatic - drug therapy; Biological and medical sciences; Biomarkers - blood; Cartilage Oligomeric Matrix Protein - blood; Dermatology; Diseases of the osteoarticular system; Diseases of the spine; Etanercept; Female; Humans; Immunoglobulin G - therapeutic use; Inflammatory joint diseases; Infliximab; Male; Matrix Metalloproteinase 3 - blood; Medical sciences; Middle Aged; Osteoprotegerin - blood; Psoriasis. Parapsoriasis. Lichen; Receptors, Tumor Necrosis Factor - therapeutic use; Severity of Illness Index; Treatment Outcome; Tumor Necrosis Factor-alpha - antagonists & inhibitors; TUMOR NECROSIS FACTOR INHIBITORS; Skin disease; Psoriasis; Diseases of the osteoarticular system; Rheumatology; Anti-TNF; Biological marker; Inflammatory joint disease; Psoriatic arthritis; Spondylarthropathy; BIOMARKERS; Chronic; Treatment; TREATMENT; PSORIATIC ARTHRITIS; PSORIASIS
• ISSN: 0315-162X; 1499-2752
• DOI: 10.3899/jrheum.121162

To identify soluble biomarkers associated with response to therapy with tumor necrosis factor inhibitors (TNFi) in patients with psoriatic arthritis (PsA).
The study was conducted at a PsA clinic where patients are assessed every 6 months, and serum samples are collected and stored once a year at the time of clinical assessment. Forty patients with active PsA who gave serum samples prior to treatment with TNFi and after at least 3 months of therapy were identified. Patients were classified as TNFi responders if tender joint count was < 3, swollen joint count was 0, and Psoriasis Area and Severity Index score was < 4 at the time the second sample was collected. The following biomarkers were tested by ELISA: TNF superfamily 14, matrix metalloprotease-3 (MMP-3), receptor activator of nuclear factor kappa-B ligand, osteoprotegerin, cartilage oligomeric matrix protein (COMP), CPII, C2C and C1-2C, CS-846, and highly sensitive C-reactive protein. Paired t tests and logistic regression was used for statistical analyses.
After a mean treatment duration of 11 months with TNFi (etanercept 28 patients, adalimumab 6, golimumab 4, infliximab 2), 29 patients were classified as TNFi responders. Baseline level of MMP-3 was independently associated with responder status (OR 1.067 for each 1-unit increase, p = 0.045). A reduction in MMP-3 levels with therapy increased the odds of achieving response (OR 1.213 for each 1-unit change, p = 0.030), whereas a reduction in COMP decreased the odds (OR 0.587, for each 100-unit increase, p = 0.039). None of the other biomarkers was associated with response.
Baseline as well as reduction in serum MMP-3 and increase in serum COMP are independently associated with response to TNFi therapy in patients with PsA.