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J Rheumatol. 2009 Oct;36(10):2308-13. doi: 10.3899/jrheum.081156. Epub 2009 Aug 14.

Serum osteopontin as a predictive marker of responsiveness to methotrexate in juvenile idiopathic arthritis.

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1
A. Meyer Children's Hospital, University of Florence, Firenze, Italy

Abstract

OBJECTIVE:

To evaluate if serum concentrations of osteopontin (OPN) at baseline in patients with juvenile idiopathic arthritis (JIA) represent a potential predictor of responsiveness to methotrexate (MTX).

METHODS:

At diagnosis, 60 children with active JIA received MTX in addition to nonsteroidal antiinflammatory drugs. After 12 months of MTX treatment, 30 patients were defined as responders; the 30 nonresponders received anti-tumor necrosis factor-alpha therapy (etanercept) in addition to MTX; this group was then enrolled for an additional 12-month study period. No patient had received steroids within 6 weeks before entering the study. Fifty healthy children matched for sex and age acted as controls. OPN serum levels were measured at baseline, before MTX, and then at 6 and 12 months. In the nonresponder patients, OPN was evaluated again after 6 and 12 months of etanercept treatment.

RESULTS:

At baseline, OPN values were significantly higher (p = 0.0003) in JIA patients than in controls, with no significant differences among the different JIA subtypes. At baseline, OPN levels were lower in responders than in nonresponder patients (14.16 +/- 10.1 microg/ml vs 33.2 +/- 18.1 microg/ml, respectively). After 12 months of MTX treatment, OPN levels were significantly reduced in comparison to baseline in both responder and nonresponder groups (p = 0.0017, p = 0.0048, respectively). In nonresponders, etanercept significantly reduced OPN levels at 6 and 12-month followup in comparison to baseline (p = 0.002, p = 0.008, respectively). No significant differences were found among OPN levels and disease activity.

CONCLUSION:

Serum levels of OPN at baseline represent a possible marker to predict the responsiveness to MTX in patients with JIA.

PMID:
19684155
DOI:
10.3899/jrheum.081156
[Indexed for MEDLINE]
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