Article
Baseline calprotectin and visfatin levels predict radiographic spinal progression after 2 years in ankylosing spondylitis patients on TNF inhibitor therapy
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Published: | September 14, 2021 |
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Introduction: The objective of this study was to analyse whether biomarker of inflammation, bone turnover and adipokines at baseline or their change after 3 months or 2 years can predict spinal radiographic progression after 2 years in AS patients treated with TNF-α inhibitors (TNFi).
Methods: 137 consecutive AS patients from the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort were included before starting TNFi. The following serum biomarkers were measured at baseline, 3 months and 2 years with ELISA:
Markers of inflammation: calprotectin, matrix metalloproteinase-3 (MMP-3), vascular endothelial growth factor (VEGF)
Markers of bone turnover: bone-specific alkaline phosphatase (BALP), C-terminal telopeptide (sCTX), osteocalcin (OC), osteoprotegerin (OPG), procollagen typ I/II N-terminal propeptide (PINP; PIINP), sclerostin.
Adipokines: high-molecular-weight(HMW)-adiponectin, leptin, visfatin
Logistic regression was performed to examine the association between biomarker values and radiographic progression. Multivariable models were adjusted for mSASSS or syndesmophytes at baseline, elevated CRP (≥5mg/l), smoking status, male gender, symptom duration, BMI, and baseline biomarker level (the latter in models with biomarker change).
Results: Serum levels of biomarkers of inflammation and bone formation showed significant changes under TNFi therapy, whereas adipokine levels were not altered from baseline.
Figure 1 [Fig. 1]
Univariable logistic regression revealed significant associations of baseline visfatin (OR=1.106 [95%CI 1.007-1.215]) and sclerostin levels (OR=1.006 [1.001-1.011]) with mSASSS progression after 2 years. Baseline sclerostin was also associated with syndesmophyte progression (OR=1.007 [1.001-1.013]). In multivariable logistic analysis, only baseline visfatin level remained significantly associated (OR=1.465 [1.137-1.889]). Furthermore, baseline calprotectin showed a positive association with both, mSASSS (OR=1.195 [1.055-1.355]) and syndesmophyte progression (OR=1.107 [1.001-1.225]) when adjusting for known risk factors.
Univariable logistic regression showed that change of sclerostin after 3 months was associated with syndesmophyte, change of PINP level after 2 years was associated with mSASSS and change of visfatin after 2 years was associated with both measures of radiographic progression. However, those associations were lost in multivariable analysis.
Conclusion: Independent of known risk factors, baseline calprotectin and visfatin levels were associated with radiographic spinal progression after 2 years of TNFi. Although biomarkers of inflammation and bone formation showed significant changes under TNFi, these changes were not significantly related to radiographic spinal progression.
Disclosures: None declared