High serum levels of CXCL13 predict lower response to csDMARDs in both ACPA-positive and ACPA-negative early rheumatoid arthritis
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View abstract on PubMed
Summary
This summary is machine-generated.High CXCL13 levels in early rheumatoid arthritis (RA) predict poor response to methotrexate (MTX). This biomarker identifies patients needing more intensive treatment, regardless of ACPA status.
Area Of Science
- Rheumatology
- Immunology
- Biomarker Discovery
Background
- Elevated CXCL13 in rheumatoid arthritis (RA) indicates synovial inflammation and immune dysregulation.
- Understanding predictors of treatment response is crucial for optimizing early RA management.
Purpose Of The Study
- To investigate if serum CXCL13 predicts response to first-line methotrexate (MTX) in early RA.
- To assess the independent and combined predictive value of CXCL13 with ACPA and IgM-RF.
Main Methods
- Prospective cohort study of 243 early RA patients treated with MTX.
- Baseline serum CXCL13, ACPA, and IgM-RF levels were measured.
- Association of high CXCL13 with remission and need for second-line therapy was analyzed.
Main Results
- High CXCL13 independently predicted lower remission rates and increased need for second-line therapy in ACPA-positive RA patients.
- In ACPA-negative RA patients, high CXCL13 correlated with higher MTX doses for remission and predicted MTX escalation.
- Serum CXCL13 levels remained stable at 2 months post-treatment initiation.
Conclusions
- High serum CXCL13 identifies early RA patients refractory to first-line MTX.
- CXCL13 is a potential biomarker for predicting MTX response in both ACPA-positive and ACPA-negative early RA.
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