Department of Clinical Chemistry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia.
Department for Rheumatology, Physical and Rehabilitation Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
Rheumatol Int. 2020 Sep;40(9):1455-1461. doi: 10.1007/s00296-020-04607-3. Epub 2020 May 27.
Vitamin D is beneficial in patients with immune-mediated rheumatic diseases as it has been shown that it lowers the incidence risk and the level of inflammation. To examine the association between clinical outcomes and initial 25-hydroxyvitamin D [25(OH)D] concentrations in patients with the immune-mediated rheumatic diseases treated with infliximab for 9 months. This study was performed in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with infliximab for at least 38 weeks. Disease activity was assessed using Disease Activity Score (DAS28) for RA and PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, while the global assessment was performed using the Visual Analogue Scale (VAS). Patients were divided into 2 groups according to 25(OH)D concentration which was classified as deficient or non-deficient (below and above 50 nmol/L, respectively). Concentrations of infliximab (IFX) and C-reactive protein (CRP) were measured according to the manufacturer's instructions.This study was performed in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) treated with infliximab for at least 38 weeks. Disease activity was assessed using Disease Activity Score (DAS28) for RA and PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, while the global assessment was performed using the Visual Analogue Scale (VAS). Patients were divided into 2 groups according to 25(OH)D concentration which was classified as deficient or non-deficient (below and above 50 nmol/L, respectively). Concentrations of infliximab (IFX) and C-reactive protein (CRP) were measured according to the manufacturer's instructions. The study included 23 patients (14 with RA, 6 with AS and 3 with PsA), median age 54 years, 15 females. Vitamin D deficient and non-deficient groups had median initial concentrations of 38 and 61 nmol/L, respectively. DAS28 and pain on VAS calculated at the 2nd and 38th week showed a statistically significant decrease only in RA and PsA patients with vitamin D deficiency (P = 0.02 and 0.06, respectively). Lower initial concentration of 25(OH)D in patients treated with infliximab was associated with better improvement of clinical measures (DAS28 and VAS) of disease after 9 months of therapy.
维生素 D 有益于免疫介导的风湿性疾病患者，因为已经证明它可以降低发病率风险和炎症水平。本研究旨在探讨在接受英夫利昔单抗治疗 9 个月的免疫介导的风湿性疾病患者中，临床结局与初始 25-羟维生素 D [25(OH)D]浓度之间的关系。该研究纳入了接受英夫利昔单抗治疗至少 38 周的类风湿关节炎（RA）、强直性脊柱炎（AS）和银屑病关节炎（PsA）患者。采用疾病活动评分（DAS28）评估 RA 和 PsA 患者的疾病活动度，采用 Bath 强直性脊柱炎疾病活动指数（BASDAI）评估 AS 患者的疾病活动度，采用视觉模拟评分（VAS）评估整体状况。根据 25(OH)D 浓度将患者分为 2 组，分别为缺乏组和非缺乏组（低于和高于 50nmol/L）。根据制造商的说明测量英夫利昔单抗（IFX）和 C 反应蛋白（CRP）的浓度。该研究纳入了 23 名患者（14 名 RA 患者、6 名 AS 患者和 3 名 PsA 患者），中位年龄为 54 岁，女性 15 名。维生素 D 缺乏组和非缺乏组的初始浓度中位数分别为 38 和 61nmol/L。仅在维生素 D 缺乏的 RA 和 PsA 患者中，第 2 周和第 38 周时的 DAS28 和 VAS 疼痛评分显示出统计学显著下降（分别为 P=0.02 和 0.06）。接受英夫利昔单抗治疗的患者初始 25(OH)D 浓度较低与 9 个月治疗后疾病的临床指标（DAS28 和 VAS）改善相关。
