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Baseline osteopontin levels may predict efficacy of tocilizumab, but not infliximab
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Baseline serum levels of osteopontin may be predictive of the efficacy of tocilizumab — but not infliximab — in Japanese patients with rheumatoid arthritis who were naïve to biologic medications, according to recently published study results.
Researchers studied the serum biomarker profiles of 57 patients with rheumatoid arthritis treated with infliximab (Humira, AbbVie) and 70 patients treated with tocilizumab (Actemra, Genentech) between February 2010 and April 2013. In the infliximab group, the mean patient age was 55.8 years and the mean disease duration was 7.7 years. In the tocilizumab group, the mean patient age was 56.6 years and the mean disease duration was 5.9 years.
At baseline, investigators evaluated patients to measure disease activity and collected patient characteristics. Serum samples were collected immediately before the initiation of the first infusion and included screening for C-reactive protein (CRP), immunoglobulin M-rheumatoid factor, anti-cyclic citrullinated protein antibodies, interferon-, interleukin (IL)-1 beta, IL-2, IL-6, IL-8, IL-10, IL-17, tumor necrosis factor-alpha, soluble intercellular adhesion molecule-1, bone alkaline phosphatase, osteonectin and osteopontin.
During the first year of treatment, seven patients discontinued infliximab and three discontinued tocilizumab, reflecting no significant differences between groups in retention rates at 1 year.
Univariate analysis revealed no baseline variables associated with disease activity scores among patients in the infliximab group. However, of the patients treated with tocilizumab, younger age, baseline osteopontin levels, lower dose prednisolone and lower CRP levels were associated with remission at 1 year. The correlation persisted after the exclusion of patients without concomitant methotrexate.
“Our study demonstrated that low serum [full-length osteopontin] OPN levels predict clinical remission after 1-year [tocilizumab] TCZ treatment but not [infliximab] IFX treatment,” the researchers wrote. “Our prediction model provided insights into how to optimize the choice of biologics and warrants external validation in other cohorts.” – by Shirley Pulawski
Disclosures: Izumi reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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