Impact of serum interleukin-22 as a biomarker for the differential use of molecular targeted drugs in psoriatic arthritis: a retrospective study.

Abstract

BACKGROUND:

We explored whether serum cytokines could be used as biomarkers for optimal use of tumor necrosis factor inhibitors (TNF-i) and interleukin (IL)-17 inhibitors (IL-17-i) in patients with psoriatic arthritis (PsA).

METHODS:

In cohort 1 (47 patients treated with IL-17-i [n=23] or TNF-i [n=24] for ≥1 year), we identified serum cytokines that predicted the achievement of Disease Activity in Psoriatic Arthritis-remission (DAPSA-REM), Psoriasis Area and Severity Index (PASI) 90, and Minimal Disease Activity after 1 year of TNF-i or IL-17-i therapy. Subsequently, we developed treatment strategies based on the identified cytokines; initiation of IL-17-i therapy in patients with low IL-22 concentrations (IL-22 <0.61376 pg/ml) and TNF-i therapy in patients with high IL-22 concentrations (0.61376< IL-22 pg/ml). In cohort 2 (34 patients), treatment responses were compared between the strategic treatment group (n=17), which was treated based on the treatment strategies, and the mismatched treatment group (n=17) to verify the validity of the treatment strategies developed using serum cytokines as biomarkers.

RESULTS:

In cohort 1, serum IL-22 concentration was identified as a predictor of DAPSA-remission after 1 year of IL-17-i therapy. Regarding treatment strategies, we selected TNF-i for patients with high IL-22 concentrations and IL-17-i for those with low IL-22 concentrations. There were no significant differences in the baseline characteristics between the strategic and mismatched treatment groups. Regarding treatment effects, activity significantly improved at 1 year in both groups. Upon comparison of the treatment effects, the rate of achieving DAPSA-REM and Minimal Disease Activity at month 12 was significantly higher in the strategic treatment group.

CONCLUSIONS:

The results of this pilot study suggest that IL-22 may be a biomarker of treatment response to TNF-i and IL-17-i in patients with PsA. Further large-scale studies in independent, prospectively collected datasets are required to verify that IL-22 is indeed a biomarker of treatment response in these patients.

• Authors: Ippei Miyagawa, Shingo Nakayamada, Masanobu Ueno, Yusuke Miyazaki, Shigeru Iwata, Satoshi Kubo, Koshiro Sonomoto, Junpei Anan, Naoaki Ohkubo, Yoshino Inoue, Yoshiya Tanaka
• Journal: Arthritis research & therapy (Arthritis Res Ther) Vol. 24 Issue 1 Pg. 86 (04 15 2022) ISSN: 1478-6362 [Electronic] England
• PMID: 35428323 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Chemical References

• Antirheumatic Agents
• Biomarkers
• Cytokines
• Interleukin-17
• Interleukins

Topics

• Antirheumatic Agents (therapeutic use)
• Arthritis, Psoriatic (blood, diagnosis, drug therapy)
• Biomarkers (blood)
• Cytokines (blood)
• Humans
• Interleukin-17 (blood)
• Interleukins (blood)
• Molecular Targeted Therapy
• Pilot Projects
• Retrospective Studies
• Severity of Illness Index
• Treatment Outcome
• Interleukin-22