RESEARCH - Sex hormone concentrations in RA are not normalized during 12 weeks of anti-TNF therapy

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J Rheumatol. 2005 Jul;32(7):1253-8.

Sex hormone concentrations in patients with rheumatoid arthritis are not

normalized during 12 weeks of anti-tumor necrosis factor therapy.

Straub RH, Harle P, Atzeni F, Weidler C, Cutolo M, Sarzi-Puttini P.

OBJECTIVE: Androgens such as dehydroepiandrosterone sulfate (DHEAS) and

testosterone are markedly lower in postmenopausal women with rheumatoid

arthritis (RA) than in controls. In contrast, compared to controls, serum

levels of estrogens are normal or elevated in women with RA. Since tumor

necrosis factor (TNF) alters production of these hormones, we investigated

changes of these hormones during anti-TNF antibody (anti-TNF) therapy with

adalimumab in longstanding RA. METHODS: In this longitudinal anti-TNF

therapy study in 13 patients with long-standing RA without prior

prednisolone (7 infusions of anti-TNF: Week 0, 2, 4, 6, 8, 10, and 12), we

measured serum concentrations of interleukin 6 (IL-6), androstenedione,

DHEA, DHEAS, free testosterone, estrone, and 17ss-estradiol. Levels of these

hormones in patients were compared to serum levels of 31 age and sex matched

healthy controls. RESULTS: Upon treatment with anti-TNF, there was an

impressive decrease of clinical markers of inflammation, erythrocyte

sedimentation rate, and serum levels of IL-6. Serum levels of DHEAS and free

testosterone were markedly lower at baseline in patients compared to

controls, but this did not change during anti-TNF therapy. Serum levels of

DHEA and 17ss-estradiol were significantly elevated in patients compared to

controls, but similarly, anti-TNF therapy did not change initially increased

levels. Molar ratios of hormones, which reflect hormone shifts via

converting enzymes, showed typical alterations at baseline, but did not

change markedly during anti-TNF therapy.

CONCLUSION: Longterm therapy with anti-TNF did not change altered serum

levels of typical sex hormones in patients with RA, although baseline values

were largely different. In patients with RA, this indicates that alterations

of sex hormones and altered activity of respective converting enzymes are

imprinted for a long-lasting period over at least 12 weeks.

PMID: 15996060

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

5996060 & dopt=Abstract

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