A1 Refereed original research article in a scientific journal
Glycoprotein YKL-40: A potential biomarker of disease activity in rheumatoid arthritis during intensive treatment with csDMARDs and infliximab. Evidence from the randomised controlled NEO-RACo trial
Authors: Vaananen T, Vuolteenaho K, Kautiainen H, Nieminen R, Mottonen T, Hannonen P, Korpela M, Kauppi MJ, Laiho K, Kaipiainen-Seppanen O, Luosujarvi R, Uusitalo T, Uutela T, Leirisalo-Repo M, Moilanen E
Publisher: PUBLIC LIBRARY SCIENCE
Publishing place: SAN FRANCISCO
Publication year: 2017
Journal: PLoS ONE
Journal name in source: PLOS ONE
Journal acronym: PLOS ONE
Article number: ARTN e0183294
Volume: 12
Issue: 8
Number of pages: 15
ISSN: 1932-6203
eISSN: 1932-6203
DOI: https://doi.org/10.1371/journal.pone.0183294
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/26704888
ObjectiveYKL-40, a chitinase-like glycoprotein associated with inflammation and tissue remodeling, is produced by joint tissues and recognized as a candidate auto-antigen in rheumatoid arthritis (RA). In the present study, we investigated YKL-40 as a potential biomarker of disease activity in patients with early RA at baseline and during intensive treatment aiming for early remission.MethodsNinety-nine patients with early DMARD-naive RA participated in the NEO-RACo study. For the first four weeks, the patients were treated with the combination of sulphasalazine, methotrexate, hydroxychloroquine and low dose prednisolone (FIN-RACo DMARD combination), and subsequently randomized to receive placebo or infliximab added on the treatment for further 22 weeks. Disease activity was evaluated using the 28-joint disease activity score and plasma YKL-40 concentrations were measured by immunoassay.ResultsAt the baseline, plasma YKL-40 concentration was 57 +/- 37 ( mean +/- SD) ng/ml. YKL-40 was significantly associated with the disease activity score, interleukin-6 and erythrocyte sedimentation rate both at the baseline and during the 26 weeks' treatment. The csDMARD combination decreased YKL-40 levels already during the first four weeks of treatment, and there was no further reduction when the tumour necrosis factor-alpha antagonist infliximab was added on the combination treatment.ConclusionsHigh YKL-40 levels were found to be associated with disease activity in early DMARD-naive RA and during intensive treat-to-target therapy. The present results suggest YKL-40 as a useful biomarker of disease activity in RA to be used to steer treatment towards remission.
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