Cytokine correlates of clinical response patterns to infliximab treatment of AS

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Ann Rheum Dis. 2004 Jan; 63(1): 84-7.

Cytokine correlates of clinical response patterns to infliximab

treatment of ankylosing spondylitis.

Stone MA, Payne U, Pacheco-Tena C, Inman RD.

Department of Medicine and Division of Rheumatology, University of

Toronto, Toronto, Ontario, Canada.

OBJECTIVE: To identify clinical and immunological markers of response to

treatment with infliximab in ankylosing spondylitis (AS). METHODS:

Baseline and sequential cytokine levels (IL1, TNFalpha, IFNgamma,

TGFbeta and IL10) were examined after 52 weeks of infliximab treatment 5

mg/kg in 22 patients. RESULTS: At week 52, 18 patients were responders

and four non-responders according to ASAS group criteria. Clinical

measures of disease activity between the two groups at baseline were

similar, apart from a trend towards longer disease duration in

non-responders (p = 0.08). Baseline CRP and TNFalpha levels were higher

in responders than non-responders (p<0.01 and p<0.006, respectively).

The two groups had similar baseline cytokine levels, apart from

TNFalpha. Baseline CRP levels did not correlate significantly with

baseline cytokine levels in responders, but a strong correlation was

noted between baseline CRP and IL1, IFNgamma, and IL10 in

non-responders. Apart from an early rise in TGFbeta and a decrease in

IL10 in responders after the first infusion, sequential cytokine

analysis for the first six months of treatment was not related to

clinical disease activity measures.

CONCLUSION: Although sequential cytokine analysis does not appear to be

informative, baseline CRP and TNFalpha levels are useful markers of

clinical response patterns in patients with AS treated with infliximab.

PMID: 14672897

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