Cytokine scores did not identify active joint disease in rheumatoid arthritis (RA) patients with normal acute phase reactants (APR), according to a recent study. RA patients in a longitudinal observational registry with available cytokine array data were included. Patients were categorized based on agreement/disagreement of physical examination and APR measurements: concordant high (CH) [high tender and/or swollen joint counts (TJC + SJC > 3) and APR (erythrocyte sedimentation rate [ESR] ≥ 28 mm/h + C-reactive protein [CRP] ≥ 1.5 mg/L)]; concordant low (CL) [TJC + SJC ≤ 3 and normal APR]. Discordant (D) [TJC + SJC > 3 and normal APR] patients were stratified into low, medium, and high-disease activity (DL, DM, DH). Researchers found:
- RA patients (n=1,467) were predominantly male (91%).
- Compared to CH patients (n=174), D (n=434) were younger, less frequently seropositive, with lower TJC, SJC, and Disease Activity Score (DAS28-3v) scores.
- Cytokine scores for DL, DM, and DH groups were lower than CH patients and did not differ between DL, DM, and DH subgroups and were similar to CL (n=356) patients.
- In multivariable analyses including CH and D patients, log-cytokine score was associated with higher DAS28-3v scores.
Alex AM, Sayles H, Mikuls TR, Kerr GS. Evaluation of cytokine profiles in rheumatoid arthritis patients with clinically active disease and normal inflammatory indices. [Published online ahead of print December 1, 2018]. Clin Rheumatol. doi:10.1007/s10067-018-4379-5.