Urinary prostanoids are elevated by anti-TNF and anti-IL6 receptor disease-modifying antirheumatic drugs but are not predictive of response to treatment in early rheumatoid arthritis
Authors' conclusion
Treatment with anti-TNF or anti-IL6R agents in early RA patients leads to an increased systemic production of proinflammatory and prothrombotic prostanoids. However, urinary eicosanoid levels do not appear to be predictive of the response to DMARDs therapy.
Study context
- Population
- Swedish female patients with early rheumatoid arthritis (RA), all rheumatoid factor (RF) positive, enrolled in the NORD-STAR trial
- Participants
- 152 patients
- Comparison
- Methotrexate (MTX) plus prednisolone vs MTX plus certolizumab pegol vs MTX plus abatacept vs MTX plus tocilizumab
- Primary endpoint
- Change in urinary prostanoid levels (tPGEM, tetranor-prostaglandin D metabolite (tPGDM), TXBM, PGIM, leukotriene E4 (LTE4), 12-HETE) by liquid chromatography-mass spectrometry (LC-MS)
- Follow-up
- 24 weeks
Methodological detailsgeneralized estimating equation models
- Generalized estimating equation models
Primary result
As reported in the abstract
Change in urinary eicosanoids
- Significant elevations in urinary tetranor-prostaglandin E metabolite (tPGEM) and TXBM with MTX plus CZP or TCZ
- Other eicosanoids did not show significant alterations with any treatment
Further findings
Correlation of urinary eicosanoids with clinical outcomes (clinical disease activity index (CDAI)) · week 24
- Baseline urinary eicosanoids did not correlate with baseline CDAI, nor with change in CDAI to week 24
- Levels similar between patients in CDAI remission and those with active disease at week 24
Original publication
Urinary prostanoids are elevated by anti-TNF and anti-IL6 receptor disease-modifying antirheumatic drugs but are not predictive of response to treatment in early rheumatoid arthritis. Arthritis Res Ther. Published 5 March 2024. doi:10.
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