The Role of Anti-TNFα Therapy in the Amelioration of Disease Burden in Patients with Refractory Rheumatoid Arthritis

Abstract

To evaluate the changes in anti cyclic citrullinated peptide (Anti-CCP) antibodies,
rheumatoid factor (RF), interleukins 17 and 10 (IL-17 and IL-10), high sensitivity C- reactive
protein (hs CRP) and T regulatory cells (Treg) count following an anti TNF-α biological agent
(etanercept) therapy in patients with rheumatoid arthritis.
Refractory rheumatoid arthritis patients who failed treatment with DMARDs (disease
modifying anti rheumatic drugs) were treated with etanercept for three months. Serum and blood
samples were tested before and after therapy for six markers including ACCP, RF, IL- 10, IL 17,
hs CRP, and Treg cell. A significant dropping down in the serum level of ACCP, RF and hs CRP
was documented 3 months after etanercept therapy. On the other hand a non- significant elevation
in IL-10 serum level and peripheral blood Treg cell count, as well as a non significant dropping
down in the serum level of IL-17 were also reported. Etanercept is a successful anti-TNF-α
therapy in refractory RA patients for the first three months of the course therapy as indicated by
clinical improvement and amelioration in 6 disease activity markers.