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Biological therapy of rheumatoid arthritis: is it a real prediction of efficacy?

[Internal diseases]
Pavel Koroy; Vijaya Sarithala; Alexandr Yagoda;

Relationship of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), plateletendothelial cell adhesion molecule-1 (PECAM-1), E-, P- and L-selectins blood levels with results of three-monthly combination treatment by biological agents and methotrexate was studied in 35 patients with rheumatoid arthritis (29 women, 6 men) at age from 40 to 66 with previous noneffective methotrexate treatment. Tocilizumab was applied in 20 patients, in 15 cases etanercept was used. The moderate effect of treatment was observed in 74.3 % of cases, remission or low activity of rheumatoid arthritis were reached in 22.9 % of patients, 9 patients were non-responders. Increase of blood concentration of all immunoglobulins superfamily molecules and of P-selectin was observed in rheumatoid arthritis. After 3 months of therapy decrease in VCAM-1, PECAM-1 blood levels and normalization of ICAM-1, P-selectin values were observed, especially in cases of effective treatment, in non-responders there was reduction only of ICAM-1 levels. The favorable response to treatment was associated with high initial levels of ICAM-1, РЕСАМ-1 and low levels of P-selectin in blood that opens new possibilities of use of adhesion molecules in prediction of successful therapy of RA.


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Keywords: rheumatoid arthritis, immunoglobulins superfamily molecules, selectins, biological therapy, prediction of efficacy

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy