Anti-rheumatic treatment is not associated with reduction of pentraxin 3 in rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

Background: Pentraxin 3 is proposed to be a marker of inflammation and cardiovascular risk, but its role in inflammatory rheumatic diseases (IRDs) is still uncertain. Therefore, we wanted to examine if anti-rheumatic treatment reduced serum PTX3 (s-PTX3) levels in IRDs, and if s-PTX3 levels were related to other markers of inflammation and to endothelial function (EF). Methods: We examined s-PTX3, EF and established inflammatory biomarkers in 114 IRD patients from the PSARA study before and after 6 weeks and 6 months of treatment with methotrexate (MTX) or anti-tumor necrosis factor alpha (anti-TNF) therapy with or without MTX co-medication. Results: s-PTX3 levels in all IRD diagnoses were above the upper limit of the reference range. In contrast to established inflammatory markers, in particular CRP and ESR, s-PTX3 levels did not change significantly after 6 weeks and 6 months of anti-rheumatic therapy. There was no difference in change in s-PTX3 levels from baseline to 6 weeks and 6 months between MTX monotherapy and anti-TNF regimens. CRP, ESR and EF were not related to changes in s-PTX3 neither in crude nor adjusted analyses. Conclusion: IRD patients have increased s-PTX3 levels, which, in contrast to other inflammatory markers, do not seem to improve within 6 months of therapy with MTX and/or anti-TNF. Thus, s-PTX3 might reflect a persisting immune process, even a causal factor of inflammation, not inhibited by the standard anti-rheumatic treatment. Furthermore, even though s-PTX3 is thought to be a strong predictor of cardiovascular prognosis, it was not related to EF

PTX3 and established markers of disease activity at baseline, 6 weeks and 6 months of treatment.

<p>Values are given in median. IRD, inflammatory rheumatic disease; RA, rheumatoid arthritis; PsA, psoriatic arthritis; AS, ankylosing spondylitis; PTX3, pentraxin 3; WBC, white blood cells; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; PGA, Physicians Global Assessment Score of disease activity; PtGA, Patients' Global Assessment Score of disease activity. X p<0.01 for difference between the evaluation at baseline and at 6 weeks ¥ p<0.01 for difference between the evaluation at 6 weeks and 6 months.</p

Baseline patient characteristics.

<p>Baseline patient characteristics.</p

Predictors of PTX3.

<p>Predictors of PTX3.</p