SAT0116 The study of baseline serum sicam-1 and cxcl13 levels in predicting response to tumor necrosis factor-Α inhibitor therapy in patients with rheumatoid arthritis
Authors: X. Ye, J. Zhao, Z. Zhang
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> TNF-α inhibitors are not effective for each patient, leading to poor response as well as financial burden. There is an urgent need for biomarkers to assist us in individualized treatment. However, reliable biomarkers that predict therapeutic response to TNF-α inhibitors are still lacking. <h3>Objectives</h3> We aimed to investigate whether baseline serum soluble intercellular adhesion molecule-1 (sICAM-1) and C-X-C motif chemokine ligand 13 (CXCL13) could serve as biomarkers to predict therapeutic response to TNF-α inhibitor therapy in RA patients. <h3>Methods</h3> RA patients were enrolled from the 12-week TNF-α inhibitor clinical trial in our center between October 2014 and October 2017. 20 age- and gender-matched healthy controls were also recruited. Serum samples at baseline and week 12 were collected from RA patients, then serum levels of sICAM-1 and CXCL13 were measured by enzyme-linked immunosorbent assay. Clinical and laboratory data were recorded from baseline to week 12. RA patients were classified into responders and non-responders at week 12 according to EULAR response criteria. <h3>Results</h3> 51 RA patients were enrolled in this study. Serum levels of sICAM-1 and CXCL13 in RA patients were significantly higher than healthy controls (p&lt;0.001 and p&lt;0.001 respectively). Serum sICAM-1 and CXCL13 levels were higher in seropositive RA patients (p=0.012 and p=0.005 respectively). Baseline serum levels of sICAM-1 and CXCL13 were correlated with changes in ESR, DAS28-ESR, DAS28-CRP, SDAI and CDAI. Baseline serum sICAM-1 levels were higher in responders to TNF-α inhibitor therapy at week 12 by EULAR response criteria (p=0.010). However, there was no significant difference in CXCL13 levels. In addition, serum sICAM-1 and CXCL13 levels were decreased after treatment in responders (p&lt;0.001 and p&lt;0.001 respectively), nevertheless, non-responders showed a rising trend (p=0.086 and p=0.051 respectively). Binary logistic regression model revealed that baseline serum sICAM-1 levels had a positive effect on response to therapy. ROC curve analysis for predictive ability of baseline serum sICAM-1 showed an area under the curve (AUC) of 0.775 (p=0.010). <h3>Conclusions</h3> Serum sICAM-1 and CXCL13 levels were elevated in RA patients, and they were higher in seropositive patients than in seronegative patients. Elevated baseline serum sICAM-1 levels were associated with favorable response to TNF-α inhibitor therapy. The decrease of serum sICAM-1 levels after treatment in responders was consistent with their therapeutic response. Thus, baseline serum sICAM-1 could be a predictive biomarker for TNF-α inhibitor therapy in RA patients. There was a lack of reliable evidence that baseline serum CXCL13 had predictive ability, possibly due to different mechanisms of action or small sample size. <h3>References:</h3> [1] Zampeli E, Vlachoyiannopoulos PG, Tzioufas AG. Treatment of rheumatoid arthritis: Unraveling the conundrum[J]. J Autoimmun 2015;65:1-18. [2] Smolen JS, Aletaha D. Rheumatoid arthritis therapy reappraisal: strategies, opportunities and challenges[J]. Nat Rev Rheumatol 2015;11(5):276-89. [3] Lindstrom TM, Robinson WH. Biomarkers for rheumatoid arthritis: making it personal[J]. Scand J Clin Lab Invest Suppl, 2010;242:79-84. <h3>Acknowledgements:</h3> PUCRP 201305 <h3>Disclosure of Interest:</h3> None declared