SYSTEMIC CYTOKINE MEASUREMENTS - THEIR ROLE IN MONITORING THE RESPONSE TO THERAPY IN PATIENTS WITH RHEUMATOID-ARTHRITIS

Objective. To determine the value of serial measurements of circulatin g cytokines in patients with rheumatoid arthritis in response to the i ntroduction of disease modifying anti-rheumatic drugs (DMARDs). Method s. A prospective 12-week study of 98 patients starting second line the rapy with serial measurements of IL1 beta, IL2 receptor, IL6, TNF, and urinary neopterins as well as ESR, CRP and rheumatoid factor. Results . The markers of the acute phase response fell significantly with trea tment as did the rheumatoid factor. IL-6 fell in certain sub-groups (s ignificantly so after sulphasalazine SZP) of treated patients, but no other consistent change in circulating cytokine levels was demonstrate d Urinary neopterins rose with therapy. Conclusions. The measurement o f circulating cytokine levels in patients with rheumatoid arthritis is of limited limited benefit; macrophage function (as measured by urina ry neopterins) is initially enhanced by DMARDs inpatients with rheumat oid arthritis.