ObjectiveTo evaluate circulating visfatin and its relationship with disease activity and serum lipids in patients with early, treatment-naïve rheumatoid arthritis (RA).MethodsSerum visfatin was measured in 40 patients with early RA before and after three months of treatment and in 30 age- and sex-matched healthy individuals. Disease activity was assessed using the Disease Activity Score for 28 joints (DAS28) at baseline and at three and 12 months. Multivariate linear regression analysis was performed to evaluate whether improved disease activity is related to serum visfatin or a change in visfatin level.ResultsSerum visfatin was significantly elevated in early RA patients compared to healthy controls (1.92±1.17 vs. 1.36±0.93 ng/ml; p = 0.034) and significantly decreased after three months of treatment (to 0.99±0.67 ng/ml; p<0.001). Circulating visfatin and a change in visfatin level correlated with disease activity and improved disease activity over time, respectively. A decrease in visfatin after three months predicted a DAS28 improvement after 12 months. In addition, decreased serum visfatin was not associated with an improved atherogenic index but was associated with an increase in total cholesterol level.ConclusionA short-term decrease in circulating visfatin may represent an independent predictor of long-term disease activity improvement in patients with early RA.

Interleukin-21 (IL-21) plays an important role in the pathogenesis of rheumatoid arthritis (RA). The aim of our study was to assess serum levels of IL-21 in patients with recent-onset RA in relation to disease activity and response to treatment. We analyzed serum levels of IL-21 in 51 RA patients, both before and 12 weeks after the initiation of treatment and in 36 healthy individuals. Disease activity was assessed at baseline and at weeks 12 and 24 using the Disease Activity Score for 28 joints, serum levels of C-reactive protein, and the total swollen joint count. We found that IL-21 levels were not increased in patients with recent-onset RA compared with healthy controls, but they had significantly decreased from baseline to week 12 during treatment. Baseline levels of IL-21 significantly correlated with measures of disease activity (p<0.02 for all). Although IL-21 levels did not predict achievement of remission, decrease in IL-21 levels correlated with improvement in disease activity after 12 weeks (p<0.02) and also after 24 weeks (p<0.04) of treatment. Our data suggest that circulating IL-21 levels may serve as a biomarker of disease activity and better outcome in early phase of RA.

Background Identification of novel molecules contributes to better understanding of rheumatoid arthritis (RA) pathogenesis and offers promise for comprehensive identification of novel biomarkers that would allow monitoring of disease activity and individualize prognosis of RA patients. Visfatin may represent a novel biomarker of disease severity. Serum visfatin levels are elevated in RA, may be associated with the degree of inflammation, clinical disease activity and radiographic joint damage. Objectives To assess circulating visfatin and its relationship with disease activity and serum lipids in patients with early treatment-naïve RA and to evaluate the effect of treatment with conventional synthetic DMARDs on visfatin levels. Methods Serum levels of visfatin were analysed in 40 patients with early RA before and after three months of treatment and in 30 age- and sex-matched healthy individuals. Disease activity was assessed by the Disease Activity Score for 28 joints (DAS28) at baseline and at months 3 and 12. Multivariate linear regression analysis was performed to evaluate whether disease activity improvement can be related to serum circulating visfatin or to a change of visfatin levels. Results Visfatin serum levels were significantly elevated in early RA patients compared with healthy controls (1.92±1.17 vs. 1.36±0.93 ng/ml; p=0.034) and significantly decreased after three months of treatment (to 0.99±0.67 ng/ml; p<0.001). Circulating visfatin and change in visfatin levels correlated with disease activity and disease activity improvement over time, respectively. Visfatin decrease after three months predicted DAS28 improvement after 12 months (p=0.031, adjusted R2=10.1%). In addition, decrease of serum visfatin levels was not associated with improved atherogenic index, but was negatively associated with the increase of total cholesterol levels. Conclusions Short-term decrease in circulating visfatin levels may represent independent predictor of long-term disease activity improvement in patients with early RA. Acknowledgements This study was supported by Internal Grant Agency of Ministry of Health of the Czech Republic NT/13696-4 and Research Project No. 00023728. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.4092