Serum S100A8/A9 and S100A12 Levels in Children With Polyarticular Forms of Juvenile Idiopathic Arthritis: Relationship to Maintenance of Clinically Inactive Disease During Anti-Tumor Necrosis Factor Therapy and Occurrence of Disease Flare After Discontinuation of Therapy.
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| Abstract | OBJECTIVE: To determine the relationship between serum levels of S100A8/A9 and S100A12 and the maintenance of clinically inactive disease during anti-tumor necrosis factor (anti-TNF) therapy and the occurrence of disease flare following withdrawal of anti-TNF therapy in patients with polyarticular forms of juvenile idiopathic arthritis (JIA). METHODS: In this prospective, multicenter study, 137 patients with polyarticular-course JIA whose disease was clinically inactive while receiving anti-TNF therapy were enrolled. Patients were observed for an initial 6-month phase during which anti-TNF treatment was continued. For those patients who maintained clinically inactive disease over the 6 months, anti-TNF was withdrawn and they were followed up for 8 months to assess for the occurrence of flare. Serum S100 levels were measured at baseline and at the time of anti-TNF withdrawal. Spearman's rank correlation test, Mann-Whitney U test, Kruskal-Wallis test, receiver operating characteristic (ROC) curve, and Kaplan-Meier survival analyses were used to assess the relationship between serum S100 levels and maintenance of clinically inactive disease and occurrence of disease flare after anti-TNF withdrawal. RESULTS: Over the 6-month initial phase with anti-TNF therapy, the disease state reverted from clinically inactive to clinically active in 24 (18%) of the 130 evaluable patients with polyarticular-course JIA; following anti-TNF withdrawal, 39 (37%) of the 106 evaluable patients experienced a flare. Serum levels of S100A8/A9 and S100A12 were elevated in up to 45% of patients. Results of the ROC analysis revealed that serum S100 levels did not predict maintenance of clinically inactive disease during anti-TNF therapy nor did they predict disease flare after treatment withdrawal. Elevated levels of S100A8/A9 were not predictive of the occurrence of a disease flare within 30 days, 60 days, 90 days, or 8 months following anti-TNF withdrawal, and elevated S100A12 levels had a modest predictive ability for determining the risk of flare within 30, 60, and 90 days after treatment withdrawal. Serum S100A12 levels at the time of anti-TNF withdrawal were inversely correlated with the time to disease flare (r = -0.36). CONCLUSION: Serum S100 levels did not predict maintenance of clinically inactive disease or occurrence of disease flare in patients with polyarticular-course JIA, and S100A12 levels were only moderately, and inversely, correlated with the time to disease flare.
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| Authors | Claas H Hinze, Dirk Foell, Anne L Johnson, Steven J Spalding, Beth S Gottlieb, Paula W Morris, Yukiko Kimura, Karen Onel, Suzanne C Li, Alexei A Grom, Janalee Taylor, Hermine I Brunner, Jennifer L Huggins, James J Nocton, Kathleen A Haines, Barbara S Edelheit, Michael Shishov, Lawrence K Jung, Calvin B Williams, Melissa S Tesher, Denise M Costanzo, Lawrence S Zemel, Jason A Dare, Murray H Passo, Kaleo C Ede, Judyann C Olson, Elaine A Cassidy, Thomas A Griffin, Linda Wagner-Weiner, Jennifer E Weiss, Larry B Vogler, Kelly A Rouster-Stevens, Timothy Beukelman, Randy Q Cron, Daniel Kietz, Kenneth Schikler, Jay Mehta, Tracy V Ting, James W Verbsky, Anne B Eberhard, Bin Huang, Edward H Giannini, Daniel J Lovell |
| Journal | Arthritis & rheumatology (Hoboken, N.J.) (Arthritis Rheumatol) Vol. 71 Issue 3 Pg. 451-459 (03 2019) ISSN: 2326-5205 [Electronic] United States |
| PMID | 30225949 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't) |
| Copyright | © 2018, American College of Rheumatology. |
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