Circulating Adipokines and Response to Treatment in Patients With Early Rheumatoid Arthritis.

Area of Science:

• Rheumatology
• Immunology
• Endocrinology

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation.
• Adipokines, such as adiponectin, leptin, and resistin, are signaling proteins produced by adipose tissue with potential roles in inflammation.
• Understanding predictors of treatment response in early RA is crucial for optimizing patient outcomes.

Purpose of the Study:

• To investigate the association between baseline levels of adiponectin, leptin, and resistin and the response to antirheumatic treatments in patients with early, untreated RA.
• To determine if these adipokines can predict the likelihood of achieving clinical remission.

Main Methods:

• A cohort of 341 participants with early RA from the Nordic Rheumatic Diseases Strategy Trials and Registries trial were randomized to methotrexate plus prednisolone, certolizumab, abatacept, or tocilizumab.
• Plasma adipokine levels (adiponectin, leptin, resistin) were measured at baseline using enzyme-linked immunosorbent assay.
• Remission was defined as Clinical Disease Activity Index (CDAI) ≤2.8 at 48 weeks, with analyses stratified by median adipokine levels and adjusted Cox proportional hazards models.

Main Results:

• Higher baseline resistin levels were associated with increased C-reactive protein (CRP) and joint swelling at baseline, but adiponectin and leptin were not.
• No significant differences in mean CDAI or CDAI change were observed between participants with above-median versus below-median baseline adipokine levels.
• Baseline adiponectin, leptin, and resistin levels did not significantly predict the likelihood of achieving CDAI remission at 48 weeks (all P > 0.25).

Conclusions:

• Baseline levels of adiponectin, leptin, and resistin are not associated with the likelihood of achieving clinical remission in patients with early RA treated for up to 48 weeks.
• These adipokines do not appear to be reliable biomarkers for predicting treatment response in this early RA cohort.
• Further research may be needed to explore other potential biomarkers or factors influencing RA treatment outcomes.