Glucocorticoids in Rheumatoid Arthritis: Almost Always or Hardly Ever?

Blanco-Morales, E. Alonso; Acosta, José María; Romero, Esteban Rubio; González, Eulàlia; Pedraza, María Ángeles Gantes

doi:10.1016/j.reumae.2011.01.006

Cited by 1 publication

(1 citation statement)

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“…However, when the characteristic inflammation process is present in RA and oral glucocorticoids are introduced to therapy, the pharmacological dosage should be superior to the endogenous glucocorticoid concentration to counter-regulate the effects of MIF 41 . Oral glucocorticoids in low doses are considered as disease-modifying antirheumatic drugs due to their genomic effect by inhibiting inflammatory genes, but are used in RA with caution due to their side effects 42,43 . In this regard, our results confirm MIF's relationship with glucocorticoids due to the significantly lower MIF serum levels in RA patients prescribed with oral glucocorticoids.…”

Section: Discussionmentioning

confidence: 99%

MIF and TNFαserum levels in rheumatoid arthritis patients treated with disease-modifying antirheumatic drugs: a cross-sectional study

Brennan-Bourdon

Cruz-Mosso

Reyes-Castillo

et al. 2015

Immunopharmacology and Immunotoxicology

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Macrophage migration inhibitory factor (MIF) and tumor necrosis factor alpha (TNFα) play a pivotal role in rheumatoid arthritis (RA). MIF is considered a relevant cytokine because it appears before TNFα in the inflammatory cascade thus stimulating TNFα production and MIF's relationship with traditional synthetic disease modifying antirheumatic drugs (sDMARDs) is unknown. In this cross-sectional study, we investigated the association of MIF and TNFα serum levels with methotrexate (MTX) and in combination with chloroquine (CLQ) and sulfasalazine (SSZ) in RA patients classified according to the ACR/EULAR 2010 criteria. Patients were divided into three groups: MTX-monotherapy group (n = 40), MTX combination therapy groups: MTX + CLQ (n = 41), and MTX + CLQ + SSZ (n = 42). MIF and TNFα serum levels were determined by ELISA. We found high levels of ESR, CRP, RF, and anti-CCP in all therapy groups. Furthermore, we subclassified 97 patients with established RA (≥2 years of disease duration) and found that TNFα serum levels were lower in the combination therapy group (MTX + CLQ + SSZ) in comparison with the monotherapy MTX group (16.7 pg/mL versus 13.6 pg/mL, p = 0.02). However, we did not find differences between sDMARD therapies in MIF serum levels. We did find a significant reduction in MIF serum levels in patients treated with oral steroids compared with patients without oral steroids (1.7 ng/mL versus 4.3 ng/mL, p < 0.001). In conclusion, this study supports the role of sDMARDs in modifying TNFα serum levels and oral steroids MIF serum levels. Nevertheless, we found that MIF serum levels are not modified by sDMARD treatment.

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Section: Discussionmentioning

confidence: 99%