Journal
RHEUMATOLOGY
Volume 52, Issue 8, Pages 1467-1476Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/ket152
Keywords
juvenile idiopathic arthritis; methotrexate; response to treatment; biomarker; paediatric; rheumatology; disease outcome; CHARM study
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Funding
- SPARKS UK [08ICH09]
- Big Lottery Fund UK [RG/1/010135231]
- UK Medicines for Children Research Network
- Great Ormond Street Hospital Children's Charity
- Bundesministerium fur Bildung und Forschung (AID-NET) [01GM08100]
- FP7 programme (Pharmachild) [GA-No 260353]
- Interdisciplinary Centre of Clinical Research at the University of Muenster [IZKF CRA04]
- Sparks Charity [08ICH09, 12ICH08] Funding Source: researchfish
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Methods. JIA patients were recruited into the Childhood Arthritis Response to Medication Study (CHARMS). Clinical data and venous blood were collected before administration of MTX and at follow-up. MRP8/14 and inflammatory cytokines were measured by ELISA and multiplex immunoassay, respectively. CRP and ESR were measured as part of routine clinical assessment. To explore which baseline factors might predict successful treatment, binary logistic regression models were fitted for outcome. Results. High disease activity (high serum MRP8/14, active joint count or physician's score) pre-MTX was observed in a subgroup of patients with a better response to therapy. In a multivariable analysis, after accounting for MRP8/14 at baseline, no other factors were independently significantly associated with outcome. Patients with baseline MRP8/14 > 3000 ng/ml were more likely to respond to MTX at ACR50 or better: odds ratio 16.07 (95% CI 2.00, 129.3). Conclusion. We have demonstrated that high levels of baseline serum MRP8/14 have prognostic value in predicting a subgroup of patients whose arthritis will improve on MTX. Routine collection of serum prior to the start of medication would be a valuable step in collaborative validation of such biomarkers.
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