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Differential response of serum amyloid A to different therapies in early rheumatoid arthritis and its potential value as a disease activity biomarker

Hwang, YG and Balasubramani, GK and Metes, ID and Levesque, MC and Bridges, SL and Moreland, LW (2016) Differential response of serum amyloid A to different therapies in early rheumatoid arthritis and its potential value as a disease activity biomarker. Arthritis Research and Therapy, 18 (1). ISSN 1478-6354

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Abstract

© 2016 Hwang et al. Background: The aim was to compare the effect of etanercept (ETN) and conventional synthetic disease-modifying anti-rheumatic drug (DMARD) therapy on serum amyloid A (SAA) levels and to determine whether SAA reflects rheumatoid arthritis (RA) disease activity better than C-reactive protein (CRP). Methods: We measured SAA and CRP at baseline, 24, 48, and 102 week follow-up visits in 594 patients participating in the Treatment of early RA (TEAR) study. We used Spearman correlation coefficients (rho) to evaluate the relationship between SAA and CRP and mixed effects models to determine whether ETN and methotrexate (MTX) treatment compared to triple DMARD therapy differentially lowered SAA. Akaike information criteria (AIC) were used to determine model fits. Results: SAA levels were only moderately correlated with CRP levels (rho = 0.58, p < 0.0001). There were significant differences in SAA by both visit (p = 0.0197) and treatment arm (p = 0.0130). RA patients treated with ETN plus MTX had a larger reduction in SAA than patients treated with traditional DMARD therapy. Similar results were found for serum CRP by visit (p = 0.0254) and by treatment (p < 0.0001), with a more pronounced difference than for SAA. Across all patients and time points, models of the disease activity score of 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) using SAA levels were better than models using CRP; the ΔAIC between the SAA and CRP models was 305. Conclusions: SAA may be a better biomarker of RA disease activity than CRP, especially during treatment with tumor necrosis factor (TNF) antagonists. This warrants additional studies in other cohorts of patients on treatment for RA. Trial registration: (ClinicalTrials.gov identifier: NCT00259610 , Date of registration: 28 November 2005)


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Hwang, YGYGH2@pitt.eduYGH2
Balasubramani, GKBalaGK@edc.pitt.eduBKG100000-0001-7221-1825
Metes, IDidm2@pitt.eduIDM2
Levesque, MC
Bridges, SL
Moreland, LWlwm5@pitt.eduLWM5
Date: 17 May 2016
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: Arthritis Research and Therapy
Volume: 18
Number: 1
DOI or Unique Handle: 10.1186/s13075-016-1009-y
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
School of Medicine > Immunology
Refereed: Yes
ISSN: 1478-6354
Date Deposited: 22 Jul 2016 19:06
Last Modified: 02 Feb 2019 15:55
URI: http://d-scholarship.pitt.edu/id/eprint/28669

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