The effect of infliximab plus methotrexate on the modulation of inflammatory disease markers in juvenile idiopathic arthritis: analyses from a randomized, placebo-controlled trial.

IRCCS G, Gaslini and University of Genoa, Genoa, Italy. .
Pediatric Rheumatology (Impact Factor: 1.62). 09/2010; 8:24. DOI: 10.1186/1546-0096-8-24
Source: PubMed

ABSTRACT We evaluated the effect of infliximab on markers of inflammation in patients with juvenile idiopathic arthritis (JIA).
In this randomized, placebo-controlled substudy, 122 patients with JIA received infliximab 3 mg/kg + methotrexate (MTX)(n = 60) or placebo + MTX (n = 62) at weeks 0, 2, and 6. At week 14, patients receiving placebo + MTX crossed over to infliximab 6 mg/kg + MTX; patients receiving infliximab 3 mg/kg + MTX continued treatment through week 44. Sera and plasma from eligible patients receiving infliximab 3 mg/kg + MTX (n = 34) and receiving placebo→infliximab 6 mg/kg +MTX (n = 38) were collected at weeks 0, 2, 14, 16, 28, and 52 and analyzed for inflammatory markers (IL-6, IL-12p40, ICAM-1, MMP-3, VEGF, TNF-α, and CRP).
At week 2, decreases from baseline in IL-6, ICAM-1, MMP-3, TNF-α, and CRP were greater with infliximab versus placebo treatment, and with the exception of CRP, these differences were generally maintained through week 14. The decreases from baseline to week 52 in IL-6, ICAM-1, VEGF, MMP-3, and CRP and increases in IL-12p40 levels were larger in patients receiving placebo→infliximab 6 mg/kg +MTX versus infliximab 3 mg/kg + MTX treatment. Patients receiving infliximab 3 mg/kg+MTX who achieved an American College of Rheumatology Pediatric 30 (ACR-Pedi-30) response had significantly larger decreases from baseline in ICAM-1 (p = 0.0105) and MMP-3 (p = 0.0253) at week 2 and in ICAM-1 (p = 0.0304), MMP-3 (p = 0.0091), and CRP (p = 0.0011) at week 14 versus ACR-Pedi-30 nonresponders.
Infliximab + MTX attenuated several inflammatory markers in patients with JIA; larger decreases in ICAM-1, MMP-3, and CRP levels were observed in ACR-Pedi-30 responders versus nonresponders.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The identification and clinical demonstration of efficacy and safety of osteo- and chondro-protective drugs are met with certain difficulties. During the last few decades, the pharmaceutical industry has, in the field of rheumatology, experienced disappointments associated with the development of disease modification. Today, the vast amount of patients suffering from serious, chronic joint diseases can only be offered treatments aimed at improving symptoms, such as pain and acute inflammation, and are not aimed at protecting the joint tissue. This huge, unmet medical need has been the driver behind the development of improved analytical techniques allowing better and more efficient clinical trial design, implementation and analysis. With this review, we aim to provide a brief and general overview of biochemical markers of joint tissue, with special focus on neoepitopes. Furthermore, we highlight recent studies applying biochemical markers in joint degenerative diseases. These disorders, including osteoarthritis, rheumatoid arthritis and spondyloarthropathies, are the most predominant disorders in Europe and the USA, and have enormous socioeconomical impact.
    Biomarkers in Medicine 06/2014; 8(5):713-31. DOI:10.2217/bmm.13.144 · 2.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The demonstration of the quantitative prevalence of specific cytokines in JIA formed the basis for the introduction of biological anticytokine drugs to treatment. Routine assessment of the concentration of these cytokines in blood serum may enable earlier decision making on the legitimacy of biological treatment (anti-TNF). The aim of the study was to assess the diagnostic value of TNFalpha, IL-6, and IL-1beta in monitoring the course of the disease and effectiveness of treatment with etanercept of children with oligo- and polyarticular JIA.
    Clinical laboratory 01/2014; 60(9):1481-90. DOI:10.7754/Clin.Lab.2013.130734 · 1.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Psoriatic arthritis (PsA) is a chronic, progressive, inflammatory spondyloarthropathy that affects approximately one-third of patients with all types of psoriasis. Dermatologists are in a unique position to recognize early symptoms of PsA, initiate appropriate therapy, and prevent development of further disability. The course of PsA can be modulated by immunosuppressive therapy; patients with moderate-to-severe disease require aggressive management with medications proven to halt disease progression. It is essential for the dermatologist to understand the safety, tolerability, efficacy, cost, and potential to halt disease progression with available medications for this relatively common and potentially disabling disease.
    Dermatologic Clinics 11/2014; 33(1). DOI:10.1016/j.det.2014.09.010 · 1.43 Impact Factor

Full-text (4 Sources)

Available from
May 26, 2014