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CLINICAL IMPLICATIONS OF ALPHA TNF LEVELS IN RHEUMATOID ARTHRITIS

L. MUFLIC, I. ION

Abstract

Introduction. Rheumatoid arthritis is a chronic inflammatory disease with progressive erosive joint damage. The sometimes reduced effectiveness of conventional immunosuppressive treatments, their multiple adverse effects, and the overall difficulty in managing sinusoidal clinical panel (with critical periods or “peaks” and intercritical periods with varying degrees of activity) motivated the search for therapeutic alternatives for controlling the underlying disease. Material and methods. This is a prospective observational study on patients with rheumatoid arthritis receiving anti-TNF alpha biologic therapy found by two rheumatologist investigators during 3 years. From this group we selected those patients receiving anti-TNF? biological therapy. A study group of 15 patients was followed, as well as a control batch of 6 patients with the same diagnosis. In our study the individual TNF alpha level was determined by chemiluminescence detection by immunochemical method. Clinical data included the presence and quantification of painful and swollen joints, the presence of morning stiffness, and the functional scores of patients. Results and discussions. The study group (15 patients) consists of 14 women (93.3%) and one male. Comparisons of the mean values of TNF alpha between the subgroups presenting joint pain and the non-pain subgroup reveals a statistically significant difference in favor of the pain subgroup (514.47 vs 218.34), p = 0.016. We observed shows a net difference of TNF alpha levels in favor of those with arthritis (577.67 vs 375.28), but without a significant statistical correlation (p = 0.876). Conclusions. The data collected so far in our study shows a strong correlation between subjective parameters (like the joint pain) and the level of TNF alpha, indicating a weak control of the disease clinically, in the context of an insufficiently inhibited level of TNF alpha in the patient's serum.

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