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Infliximab equivalently suppresses oxidative stress compared to tocilizumab among well‐controlled patients with rheumatoid arthritis
Author(s) -
Kizaki Kazuha,
Yamashita Fumiharu,
Hayashi Tomoya,
Funakoshi Noboru
Publication year - 2018
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12972
Subject(s) - medicine , tocilizumab , erythrocyte sedimentation rate , rheumatoid arthritis , infliximab , albumin , gastroenterology , c reactive protein , oxidative stress , creatinine , immunology , disease , inflammation
Aim This study was designed to investigate which biological agent, infliximab or tocilizumab, would more intensively keep suppressing oxidative stress among well‐controlled patients as C‐reactive protein (CRP) levels normalized in rheumatoid arthritis (RA). In addition, it was intended to clarify indicative factors of oxidative stress among well‐controlled patients with RA. Methods We recruited 61 well‐controlled (CRP < 0.3 mg/dL within normal ranges) patients with RA using biological agents (infliximab n = 33; tocilizumab n = 28), active RA patients with CRP > 1.0 mg/dL ( n = 10) and healthy subjects ( n = 10) and examined the fraction of oxidized albumin (oxidized‐albumin [%]) as a marker of oxidative stress in addition to inflammatory measures and disease activity scores such as CRP, erythrocyte sedimentation rate (ESR), matrix metalloproteinase 3 (MMP‐3), serum amyloid A (SAA), Clinical Disease Activity Index, Simplified Disease Activity Index, visual analog scale (VAS), Disease Activity Index of 28 joints (DAS28)‐CRP, DAS28‐ESR and renal function (creatinine clearance [CCr]). Results Oxidized‐albumin (%) was significantly elevated among active RA patients (33.83 ± 5.31%) as compared with healthy subjects (23.00 ± 2.56%). Although oxidized‐albumin (%) among well‐controlled RA patients also increased, there was no difference with oxidized‐albumin (%) between infliximab and tocilizumab groups (26.40 ± 5.44% in infliximab; 26.62 ± 4.53% in tocilizumab). In Pearson's correlation, oxidized‐albumin (%) had significant correlations with CRP, MMP‐3, ESR, SAA, age, CCr, VAS, DAS28‐CRP and DAS28‐ESR. With those variables, multiple stepwise forward regression analysis was conducted and revealed that CCr, DAS28‐ESR and CRP are the statistically significant explanatory variables on oxidized‐albumin (%) among well‐controlled RA patients. Conclusions We demonstrated that there was no difference with infliximab and tocilizumab on oxidative stress and we clarified that CCr, DAS28‐ESR and CRP become indicative factors of oxidative stress among well‐controlled RA patients.