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Serum IL-33, a new marker predicting response to rituximab in rheumatoid arthritis.

Serum IL-33, a new marker predicting response to rituximab in rheumatoid arthritis.
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Sellam J, Rivière E, Courties A, Rouzaire PO, Tolusso B, Vital EM, Emery P, Ferraciolli G, Soubrier M, Ly B, Hendel Chavez H, Taoufik Y, Dougados M, Mariette X,


Sellam J, Rivière E, Courties A, Rouzaire PO, Tolusso B, Vital EM, Emery P, Ferraciolli G, Soubrier M, Ly B, Hendel Chavez H, Taoufik Y, Dougados M, Mariette X, (click to view)

Sellam J, Rivière E, Courties A, Rouzaire PO, Tolusso B, Vital EM, Emery P, Ferraciolli G, Soubrier M, Ly B, Hendel Chavez H, Taoufik Y, Dougados M, Mariette X,

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Arthritis research & therapy 2016 12 1318(1) 294
Abstract
BACKGROUND
Recent works have suggested a possible link between interleukin (IL)-33 and B-cell biology. We aimed to study the possible association between serum IL-33 detection and response to rituximab (RTX) in rheumatoid arthritis (RA) patients in different cohorts with an accurate enzyme-linked immunosorbent assay (ELISA).

METHODS
Serum IL-33, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), and high serum immunoglobulin (Ig)G levels were assessed in 111 RA patients receiving a first course of 2 g RTX (cohort 1) in an observational study and in 74 RA patients treated with the same schedule in routine care (cohort 2). Univariate and multivariate analyses identified factors associated with a European League Against Rheumatism (EULAR) response at 24 weeks.

RESULTS
At week 24, 84/111 (76%) and 54/74 (73%) patients reached EULAR response in cohorts 1 and 2, respectively. Serum IL-33 was detectable in only 33.5% of the patients. In the combined cohorts, the presence of RF or anti-CCP (odds ratio (OR) 3.27, 95% confidence interval (CI) 1.13-9.46; p = 0.03), high serum IgG (OR 2.32, 95% CI 1.01-5.33; p = 0.048), and detectable serum IL-33 (OR 2.40, 95% CI 1.01-5.72; p = 0.047) were all associated with RTX response in multivariate analysis. The combination of these three factors increased the likelihood of response to RTX. When serum IL-33 detection was added to seropositivity and serum IgG level, 100% of the patients with the three risk factors (corresponding to 9% of the population) responded to RTX (OR versus patients with none of the three risk factors 29.61, 95% CI 1.30-674.79; p = 0.034).

CONCLUSION
Detectable serum IL-33 may predict clinical response to RTX independently of, and synergistically with, auto-antibodies and serum IgG level.

TRIAL REGISTRATION
NCT01126541 ; 18 May 2010.

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