Circulating interleukin-6 as a biomarker in a randomized controlled trial of modified-release prednisone vs immediate-release prednisolone, in newly diagnosed patients with giant cell arteritis.

Abstract:

OBJECTIVES:To measure serial interleukin (IL)-6 levels in newly diagnosed patients with giant cell arteritis (GCA), treated in a randomized controlled trial of modified-release prednisone (MR) vs immediate-release prednisolone (IR) used in a tapering regimen conforming to British Society for Rheumatology GCA guidelines. METHODS:Patients (n = 12) were randomized into 2 treatment arms (7 MR, 5 IR) and followed over 26 weeks. We measured IL-6 with additional markers. RESULTS:A significantly higher overall mean IL-6 level (P < .05) was seen in IR (mean = 12.15, standard error [SE] = 1.90) compared with MR (mean = 4.39, SE = 1.84). Mean collagen type 1 cross-linked C-telopeptide (CTX) concentration was significantly higher (P < .05) in both groups at week 4 (mean = 0.29, SE = 0.04) compared with week 26 (mean = 0.13, SE = 0.02). MR patients had adrenocorticotropic hormone (ACTH) suppression compared with IR (P < .05) throughout without differences in cortisol levels (P = .34). No significant differences were seen between arms in other markers. CONCLUSION:Our study suggests that elevated levels of IL-6 in new GCA are better suppressed by MR prednisone compared with IR prednisolone. CTX was significantly reduced in both treatment arms indicating early metabolic effect of glucocorticoids on bone. ACTH suppression with MR prednisone may reflect a greater impact on the hypothalamic-pituitary-adrenal axis although cortisol was not affected. MR prednisone warrants further investigation in GCA.

journal_name

Int J Rheum Dis

authors

Miler E,Stapleton PP,Mapplebeck S,Mackerness C,Gayford D,Aung T,Wilson L,Schofield P,Dasgupta B

doi

10.1111/1756-185X.13702

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

1900-1904

issue

10

eissn

1756-1841

issn

1756-185X

journal_volume

22

pub_type

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