Background/Purpose: Visfatin is an insulin mimetic adipokine that has been originally described as a pre-B cell colony-enhancing factor. Association between elevated visfatin levels, disease activity and radiographic disease progression in rheumatoid arthritis (RA) were demonstrated, although the data are not consistent. The aim of this study is to investigate whether serum visfatin levels are affected by different treatments in various stages of RA.

Methods: Serum visfatin levels were determined by ELISA assay in patients with early RA (n=40) starting synthetic disease modifying anti-rheumatic drugs (DMARDs), in patients with established RA starting biologic DMARDs – adalimumab (n = 70) or rituximab (n = 31). Early RA was characterized as symptom duration £ 6 months. Fasting blood samples were collected from all patients at baseline and after three months of treatment. Visfatin levels were also evaluated in healthy controls (n=44). Disease activity was assessed based on DAS28 score. Serum levels of C-reactive protein (CRP), rheumatoid factors and anti-cyclic citrullinated peptides (anti-CCP) were measured.

Results: Baseline levels of visfatin were higher in patients with RA compared with healthy controls and correlated positively with CRP levels (r = 0.456, p = 0.003) and DAS28 (r = 0.383, p = 0.015) in patients with early RA, but not in patients with established disease. In addition, serum levels of visfatin significantly decreased after 3 months of treatment in patients with early RA (from 1.92 ± 1.17 to 0.99 ± 0.67 ng/ml; p<0.0001). Accordingly, in patients with established disease, treatment with adalimumab resulted in significant decrease of serum visfatin levels (from 2.27 ± 2.02 to 1.77 ± 1.66, p < 0.05), and treatment with rituximab resulted in significant decrease of serum visfatin levels (from 1.92 ± 1.66 to 0.94 ± 0.70, p < 0.005). The change of visfatin levels correlated positively with the change of CRP (r = 0.393, p = 0.013) and DAS28 (r = 0.425, p = 0.007) between baseline and 3 months in patients with early RA.

Conclusion:

This study shows for the first time that circulating visfatin levels are decreased following synthetic as well as biologic DMARDs in various stages of RA; however, circulating visfatin is associated with disease activity only at early phase of the disease. 

Acknowledgement: This study was supported by Internal Grant Agency of Ministry of Health of the Czech Republic NT/13696-4.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/changes-in-circulating-visfatin-levels-by-different-anti-rheumatic-treatments-a-comparison-among-synthetic-disease-modifying-anti-rheumatic-drugs-tumor-necrosis-factor-blockade-and-b-cell-depletion/