SERUM PHOSPHOLIPASE A(2) ACTIVITY IN PATIENTS WITH RHEUMATOID-ARTHRITIS BEFORE AND AFTER TREATMENT WITH METHOTREXATE, AURANOFIN, OR COMBINATION OF THE 2

Objective. (1) To confirm a previous observation that serum phospholip ase Al (PLA(2)) activity correlates with disease activity in rheumatoi d arthritis (RA); and (2) to determine whether serum PLA(2) activity c hanges after treatment with methotrexate (MTX), auranofin (AF), or a c ombination of the 2 (COMBO). Methods. Sera obtained at baseline and af ter treatment from 100 patients with RA (40 MTX, 32 AF, and 25 COMBO) who participated in a multicenter, double blind trial were tested for PLA(2) activity using an assay that measures the release of radiolabel ed C-14 oleic acid from the cell membrane of Escherichia coli. Detaile d statistical analysis was performed using previously collected clinic al data to determine whether correlations exist between RA disease act ivity and serum PLA(2) activity; whether baseline serum PLA(2) activit y predicted a therapeutic response in any treatment group; and whether there was a significant change in serum PLA(2) activity after treatme nt in patients who responded to the various drugs. Results. Baseline s erum PLA(2) activity was significantly increased in patients with RA c ompared to healthy controls. No correlation between serum PLA(2) activ ity and RA disease activity was noted at baseline. Mean serum PLA(2) a ctivity did not change significantly after treatment with MTX, AF, or COMBO in either treatment responders or nonresponders. Conclusion. Ser um PLA(2) activity is increased in patients with RA compared to health y controls, but does not correlate with disease activity in patients, nor does it predict a response to treatment with MTX, AF, or COMBO. Se rum PLA(2) activity also did not change significantly after treatment with any of the above agents.