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Psoriatic arthritis
Author(s) -
Atzeni Fabiola,
Straub Rainer H.,
Cutolo Maurizio,
SarziPuttini Piercarlo
Publication year - 2010
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2009.05363.x
Subject(s) - medicine , endocrinology , rheumatoid arthritis , etanercept , adrenocorticotropic hormone , psoriatic arthritis , dehydroepiandrosterone , androstenedione , prednisolone , prolactin , arthritis , hydrocortisone , hypothalamic–pituitary–adrenal axis , testosterone (patch) , glucocorticoid , inflammation , adrenal gland , hormone , androgen
In a chronic inflammatory disease, such as rheumatoid arthritis (RA), the hypothalamic‐pituitary‐adrenal axis is altered in three ways: (1) the inflammation‐related spontaneous and stimulated secretion of cortisol is inadequate; (2) the inflammation‐related secretion of adrenocorticotropic hormone (ACTH) is low; and (3) the levels of adrenal androgens decrease. In patients with RA, long‐term therapy with anti‐TNF therapy sensitizes the pituitary gland and improves adrenal androgen secretion. We have recently found that the mean serum levels of ACTH, cortisol, 17‐hydroxyprogesterone (17OHP), and androstenedione (ASD) in 11 prednisolone‐naïve patients with psoriatic arthritis did not markedly change during 12 weeks of etanercept treatment, nor did the serum cortisol/ACTH ratio. However, the greater increase in serum cortisol in comparison with serum 17OHP or ASD was related to clinical improvement, which indicates that the improvement was more related to the higher cortisol levels.