High resistin levels may predict increased risk of erosive disease in early active RA: Study

Ninety-nine patients with early, DMARD-naïve RA participated in the NEO-RACo study. Patients were treated for the first 4 weeks with a combination of methotrexate, sulfasalazine, hydroxychloroquine, and prednisolone (FIN-RACo treatment). Thereafter, they were randomized to receive either infliximab or placebo added to the combination for 6 months. Patients were followed for 5 years. Disease activity was evaluated using the Disease Activity Score based on 28-joint count–erythrocyte sedimentation rate, radiographs were scored with the modified Sharp–van der Heijde method, and plasma resistin concentrations were measured by immunoassay. Human THP-1 macrophages were used in the in vitro studies.

The results of the study are as follows:

· A high resistin level at baseline was associated with active inflammatory disease and predicted more rapid radiological progression during 5 year follow-up.

· Adding infliximab to the DMARD combination delayed radiological progression and overcame the poor predictive value of resistin.

· Resistin increased TNF-α production in human macrophages, indicating a possible connection between resistin and TNF-α.

Thus, the researchers concluded that high resistin concentration maybe a useful marker to distinguish patients with an increased risk of erosive disease in early active RA, and that adding TNF-α antagonist to the traditional DMARD combination may delay the radiological progression of the disease in these patients.

Reference

Pre-treatment resistin levels are associated with erosive disease in early rheumatoid arthritis treated with disease-modifying anti-rheumatic drugs and infliximab by K Vuolteenaho, L et. al published in the Scandinavian Journal of Rheumatology.

https://doi.org/10.1080/03009742.2021.1929456