Spondyloarthropathies
Abstract #2016: Comparison of the Effect of Infliximab on Inflammation and Bone Formation Biomarkers and Association With Clinical Response in Ankylosing Spondylitis and Psoriatic Arthritis
Authors: Visvanathan, et. al.
Purpose: This study was performed to evaluate changes in biomarkers associated with bone formation and inflammation in patients with PsA and AS.
Methods: The biomarkers interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), osteocalcin, bone alkaline phosphatase, and C-reactive protein were evaluated before and after Infliximab therapy (5 mg/kg) in 261 patients with ankylosing spondylitis and 107 patients with psoriatic arthritis.
Results: There was significant reduction in IL-6 and VEGF within two weeks of treatment as compared to placebo. This change was also evident at 14 weeks of therapy. There was an increase in bone alkaline phosphatase in AS patients but not psoriatic patients with treatment. Response to therapy, as measured by ACR-20 and ASA-20 occurred with reduction in IL-6 at 2 weeks and decrease in CRP at 14 weeks. Elevated baseline levels of VEGF were associated with clinical response in both groups.
Comment: This provides further evidence that specific biomarkers do change with intervention. Specifically, IL-6 response has been found to be an early marker for improvement.
Most likely there will be developed a panel of biomarkers that will be obtained on a regular basis to assess for clinical improvement. Also, these biomarkers may be used to aid in determining therapy in patients with both AS and PsA.