Etanercept May Reduce Cartilage Damage in Ankylosing Spondylitis

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Etanercept May Reduce Cartilage Damage in Ankylosing Spondylitis

NEW YORK (Reuters Health) Oct 19 - Treatment with the anti-TNF-alpha

agent etanercept appears to reduce collagen breakdown and increase

repair in patients with ankylosing spondylitis (AS), according to a

report in the October issue of the Journal of Rheumatology. Similar

benefits may occur with infliximab, a related agent.

Previous reports have shown that anti-TNF-alpha therapies can reduce

structural damage in patients with rheumatoid arthritis, but it was

unclear if the same applied to AS, lea Dr. Walter P. Maksymowych,

from the University of Alberta in Edmonton, Canada, and colleagues note.

Plain radiography has proven useful in assessing structural damage

over time with rheumatoid arthritis. With AS, however, such imaging

is not very sensitive in detecting these changes, so the researchers

used biomarkers of cartilage damage instead.

The study involved two AS cohorts: 18 patients involved in a placebo-

controlled trial of etanercept and 14 patients who were receiving

infliximab for disease refractory to conventional treatments. The

study focused on two novel biomarkers of cartilage turnover: C2C and

846 epitope.

In the trial cohort, etanercept therapy was associated with a

significant reduction in serum levels of C2C, a biomarker for

collagen degradation. At the same time, an increase was noted in

levels of 846 epitope, which suggests a possible reparative response.

The C2C changes correlated with changes in conventional inflammatory

markers, including ESR and C-reactive protein.

In the infliximab cohort, no significant changes in C2C levels were

observed, but a drop was noted in levels of matrix

metalloproteinase-1 and -3, both of which have been linked to

structural damage.

" Our data support the view that these biomarkers, and other markers

reflecting cartilage damage and repair, merit inclusion for furthers

study in clinical trials of new therapeutics for AS, " the authors

state. Larger studies are needed to validate the ability of C2C and

846 epitope to predict structural damage with AS.

J Rheumatol 2005;32:1911-1917.

http://www.medscape.com/viewarticle/514847