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Background . Rheumatoid arthritis is a systemic autoimmune disease characterized by joint erosions, progressive focal bone loss, and chronic inflammation.  Methods . 20 female patients with moderate-to-severe rheumatoid arthritis were treated with anti-TNF-antibody adalimumab in addition to concomitant antirheumatic therapies. Patients were assessed for overall disease activity using the DAS28 score, and neopterin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) concentrations as well as osteoprotegerin (OPG) and soluble receptor activator of NF- κ B ligand (sRANKL) concentrations were determined before therapy and at week 12. Neopterin as well as OPG and sRANKL were determined by commercial ELISAs.  Results . Before anti-TNF therapy patients presented with high disease activity and elevated concentrations of circulating inflammatory markers. OPG concentrations correlated with neopterin ( rs  = 0.494,  p  = 0.027), but not with DAS28. OPG concentrations and disease activity scores declined during anti-TNF-treatment (both  p  < 0.02). Patients who achieved remission ( n  = 7) or showed a good response according to EULAR criteria ( n  = 13) presented with initially higher baseline OPG levels, which subsequently decreased significantly during treatment ( p  = 0.018 for remission,  p  = 0.011 for good response).  Conclusions . Adalimumab therapy was effective in modifying disease activity and reducing proinflammatory and bone remodelling cascades.

Effects of Antitumor Necrosis Factor Therapy on Osteoprotegerin, Neopterin, and sRANKL Concentrations in Patients with Rheumatoid Arthritis