Anti-Methotrexate polyclonal antibody

Objectives: To study the bone changes and curative effect of infliximab in patients with ankylosing spondylitis (AS). Methods: AS patients diagnosed and treated in Wuwei People's Hospital from January 2017 to March 2018 were collected as the study subjects of this study, and the patients were divided into INF group (n=40) and MTX group (n=40) according to the random number table. The expression levels of TNF-alpha and IL-33 before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA), and bone changes before and after treatment were compared between the two groups. The ROC curves of TNF-alpha and IL-33 for efficacy prediction of AS were drawn and analyzed. Results: After treatment, the expression levels of serum TNF-alpha and IL-33 in patients in INF group were significantly lower than those in MTX group (P<0.001), and the improvement of bone erosion and tendon thickening in INF group was markedly higher than that in MTX group (P<0.001). The receiver operating characteristic (ROC) curve revealed that the area under the curve (AUC) of TNF-alpha for predicting efficacy was 0.939, and that of IL-33 was 0.853. Conclusions: Infliximab can significantly improve the bone status and has a positive effect in patients with AS, and TNF-alpha and IL-33 are expected to be used as efficacy predictors of AS.

Leflunomide (LEF) is a conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) for the treatment of rheumatoid arthritis. However, there are few reports on the comparison of efficacy between LEF alone and combined with other csDMARDs. Here, the efficacy and safety of LEF monotherapy (88) and combination (361) therapy groups were evaluated. After 3 months, there were no significant differences in 28-joint disease activity score (DAS28), health assessment questionnaire (HAQ), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) between the monotherapy and combination groups (all P>0.05). According to the European League Against Rheumatism (EULAR) response criteria, it was found that the DAS28 response rates were similar in the two groups (P>0.05). Besides, the two groups presented similar safety profiles. Subgroup analysis found that there was no difference in efficacy among the three combined therapies (LEF+methotrexate (MTX), LEF+hydroxychloroquine (HCQ), and LEF+MTX+HCQ) and LEF monotherapy. Furthermore, when the dose of LEF was less than 40 mg/day, no significant difference in efficacy was observed between low and high doses. Overall, these results indicated that low dose LEF monotherapy was not inferior to the combination therapy.