RESEARCH - Remicade (infliximab) treatment reduces complement activation in patients with RA

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Ann Rheum Dis. 2005 Jul;64(7):1003-8.

Infliximab treatment reduces complement activation in patients with

rheumatoid arthritis.

Familian A, Voskuyl AE, van Mierlo GJ, Heijst HA, Twisk JW, Dijkmans BA,

Hack CE.

Department of Immunopathology, Sanquin Research at the CLB, Plesmanlaan 125,

1066 CX Amsterdam, The Netherlands. A.Familian@....

BACKGROUND: Tumour necrosis factor (TNF) blocking agents decrease C reactive

protein (CRP) levels in rheumatoid arthritis (RA). It has been shown that

CRP may contribute to complement activation in RA. OBJECTIVE: To assess the

effect of intravenous infliximab treatment on complement activation,

especially that mediated by CRP, in RA. METHODS: 35 patients with active RA

(28 joint count Disease Activity Score (DAS28) >4.4) were treated with

intravenous injections of infliximab (3 mg/kg, at weeks 0, 2, 6, 14, and

22). Clinical response and plasma levels of complement activation products,

of CRP and of CRP-complement complexes, which are specific markers for CRP

mediated complement activation, were assessed at the indicated time points

up to 22 weeks. The relationship between CRP and CRP-complement complexes

was analysed by paired t test between two time points and by generalised

estimated equation, to test differences of variables over time. RESULTS: At

2 weeks after the first dose, infliximab significantly reduced overall C3

and C4 activation and plasma levels of CRP and CRP-complement complexes were

also significantly reduced at this time point. The effects of infliximab on

CRP and complement continued throughout the observation period and were more

pronounced in patients with a good response to infliximab treatment.

CONCLUSION: Treatment with infliximab decreases plasma levels of CRP and CRP

dependent complement activation products and concomitantly may reduce

complement activation in RA. Complement activation may be among the effector

mechanisms of TNF in RA.

PMID: 15958758

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5958758 & dopt=Abstract

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