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Abstract Number: 2066

Serum IL-37 Is an Efficient Biomarker of Disease Activity and Treatment Response in Patients with Ankylosing Spondylitis

Ga Young Ahn1, Su Man Kang2, Juyeon Kang1, Bora Nam1, Hyuk-Hee Kwon1, Tae-Hwan Kim3 and Dae-Hyun Yoo1, 1Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea, Republic of (South), 2Institute of Rheumatology, Hanyang University, Seoul, Korea, Republic of (South), 3Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea, Seoul, Korea, Republic of (South)

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Ankylosing spondylitis (AS), cytokines, infliximab, treatment and tumor necrosis factor (TNF)

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Session Information

Date: Tuesday, October 23, 2018

Session Title: Spondyloarthritis Including Psoriatic Arthritis – Basic Science Poster

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

The measurement of disease activity is mainly dependent on the patient-reported outcome measures in ankylosing spondylitis (AS) patients. Current inflammatory biomarkers have insufficient sensitivity and specificity to assess the disease activity and treatment response, especially after treatment with anti-TNF-α agents. Interleukin(IL)-37 is an anti-inflammatory cytokine, induced by TNF-α, and inhibits the proliferation of Th-17 cells. In AS patients, serum IL-37 level was higher in controls, and associated with CRP level and ESR. We aimed to estimate whether serum IL-37 levels reflect disease activity, and change according to the anti-TNF agent in active AS patients.

Methods:

Patients were recruited from the PLANETAS study (NCT01220518). Active AS patients with BASDAI ≥4 and visual analogue scale score for spinal pain were ≥4 were treated with infliximab originator or infliximab biosimilar, CT-P13. The serum levels of IL-37 were measured at week 0 and week 30 with specific ELISA. Other demographic, laboratory and clinical variables were evaluated simultaneously. Responders was defined as those satisfying Assessment in SpondyloArthritis International Society (ASAS 20/40) response.

Results:

Among 250 patients, 50 patients (43 males) agreed to provide their serum samples for further study. The median age of patients was 40 years old (Interquartile range [IQR], 33.8-49.5), and the median BASDAI score was 6.7 (IQR 5.3-7.9). A significant correlation between IL-37 and CRP levels (Spearman’s rho [r]=0.39, p<0.01) and BASDAI (r= 0.31, p=0.04) was observed at the baseline, but not at week 30. When calculating the overall differences (Δ) of parameters between baseline and week 30, ΔIL-37 was correlated with ΔCRP (r=0.36, p=0.02), ΔBASFI (r= 0.34, p=0.02) and ΔBASDAI (r = 0.32, p=0.03). In ASAS 20/40 responders, all the disease activity markers were significantly improved after 30 weeks of treatment. Notably, most clinical parameters except IL-37 level were decreased in both responders and non-responders. However, there was no change of serum IL-37 level in non-responders. The ROC curves for response revealed that the area under curve (AUC) value for ΔIL-37 (AUC=0.74) was similar to that for ΔESR (AUC=0.71, p=0.64) and superior than that for ΔCRP (AUC=0.54, p<0.01).

Conclusion:

Serum IL-37 levels correlated with disease activity in active AS patients. Changes in serum IL-37 levels after treatment depends on the clinical response to anti-TNF agents. Further study is required to see if earlier change of IL-37 levels after infliximab infusion can identify patients who are likely to respond to infliximab treatment.


Disclosure: G. Y. Ahn, None; S. M. Kang, None; J. Kang, None; B. Nam, None; H. H. Kwon, None; T. H. Kim, None; D. H. Yoo, None.

To cite this abstract in AMA style:

Ahn GY, Kang SM, Kang J, Nam B, Kwon HH, Kim TH, Yoo DH. Serum IL-37 Is an Efficient Biomarker of Disease Activity and Treatment Response in Patients with Ankylosing Spondylitis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/serum-il-37-is-an-efficient-biomarker-of-disease-activity-and-treatment-response-in-patients-with-ankylosing-spondylitis/. Accessed January 30, 2023.
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