Department of Medicine II, Rheumatology and Clinical Immunology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
Asklepios Klinik Altona, Rheumatology and Clinical Immunology, Paul-Ehrlich-Straße 1, 22763, Hamburg, Germany.
Arthritis Res Ther. 2022 Aug 19;24(1):200. doi: 10.1186/s13075-022-02887-7.
Assessing serological inflammation is difficult in tocilizumab (TCZ)-treated rheumatoid arthritis (RA) patients, as standard inflammation parameters, like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), are influenced by interleukin-6-receptor inhibition. Calprotectin in the serum, also named S100A8/S100A9, might be a more useful inflammation parameter in TCZ-treated patients.
Sixty-nine RA patients taking TCZ were included. Serum-calprotectin levels were assessed, as well as ESR, CRP, need for a change in disease-modifying anti-rheumatic drugs due to RA activity (= active RA), and the RA clinical disease activity score (CDAI). Forty-five RA patients taking tumor-necrosis factor-inhibitors (TNFi) were investigated for the same parameters.
TCZ-treated patients with active RA had higher calprotectin values than not active RA patients (4155.5 [inter quartile range 1865.3-6068.3] vs 1040.0 [676.0-1638.0] ng/ml, P < 0.001). A calprotectin cut-off value of 1916.5 ng/ml resulted in a sensitivity and specificity of 80.0 %, respectively, for the detection of RA disease activity. Calprotectin values correlated with CDAI-scores (r = 0.228; P = 0.011). ESR and CRP were less suitable to detect RA activity in TCZ-treated patients. Also TNFi-treated patients with active RA had higher calprotectin values compared to not active RA (5422.0 [3749.0-8150.8] vs 1845.0 [832.0-2569.0] ng/ml, P < 0.001). The calprotectin value with the best sensitivity and specificity for detecting RA activity was 3690.5 ng/ml among TNFi-treated patients.
Calprotectin in the serum can be a useful inflammation parameter despite TCZ-treatment.
托珠单抗（TCZ）治疗的类风湿关节炎（RA）患者评估血清炎症较为困难，因为标准炎症参数，如红细胞沉降率（ESR）和 C 反应蛋白（CRP），受白细胞介素-6 受体抑制的影响。血清钙卫蛋白（也称为 S100A8/S100A9）可能是 TCZ 治疗患者更有用的炎症参数。
纳入 69 例接受 TCZ 治疗的 RA 患者。评估血清钙卫蛋白水平，以及 ESR、CRP、因 RA 活动（=活动性 RA）而需要改变疾病修饰抗风湿药物的情况，以及 RA 临床疾病活动评分（CDAI）。还对 45 例接受肿瘤坏死因子抑制剂（TNFi）治疗的 RA 患者进行了相同参数的调查。
活动性 RA 的 TCZ 治疗患者的钙卫蛋白值高于非活动性 RA 患者（4155.5 [四分位距 1865.3-6068.3] vs 1040.0 [676.0-1638.0] ng/ml，P < 0.001）。钙卫蛋白截断值为 1916.5 ng/ml 时，对 RA 疾病活动的检测具有 80.0%的敏感性和特异性。钙卫蛋白值与 CDAI 评分相关（r = 0.228；P = 0.011）。ESR 和 CRP 在 TCZ 治疗患者中不太适合检测 RA 活动。此外，活动性 RA 的 TNFi 治疗患者的钙卫蛋白值也高于非活动性 RA（5422.0 [3749.0-8150.8] vs 1845.0 [832.0-2569.0] ng/ml，P < 0.001）。TNFi 治疗患者中，用于检测 RA 活动的最佳敏感性和特异性的钙卫蛋白值为 3690.5 ng/ml。
尽管接受 TCZ 治疗，血清钙卫蛋白仍可作为一种有用的炎症参数。
