The Role of Anti-TNFα Therapy in the Amelioration of Disease Burden in Patients with Refractory Rheumatoid Arthritis


Abstract:To evaluate the changes in anti cyclic citrullinated peptide (Anti-CCP) antibodies,rheumatoid factor (RF), interleukins 17 and 10 (IL-17 and IL-10), high sensitivity C- reactiveprotein (hs CRP) and T regulatory cells (Treg) count following an anti TNF-α biological agent(etanercept) therapy in patients with rheumatoid arthritis.Refractory rheumatoid arthritis patients who failed treatment with DMARDs (diseasemodifying anti rheumatic drugs) were treated with etanercept for three months. Serum and bloodsamples were tested before and after therapy for six markers including ACCP, RF, IL- 10, IL 17,hs CRP, and Treg cell. A significant dropping down in the serum level of ACCP, RF and hs CRPwas documented 3 months after etanercept therapy. On the other hand a non- significant elevationin IL-10 serum level and peripheral blood Treg cell count, as well as a non significant droppingdown in the serum level of IL-17 were also reported. Etanercept is a successful anti-TNF-αtherapy in refractory RA patients for the first three months of the course therapy as indicated byclinical improvement and amelioration in 6 disease activity markers.Key words: rheumatoid arthritis, IL-17, etanercept, Treg, TNF-α