Predictive Value of Serum Survivin Level for Clinical Efficacy of Tumor Necrosis Factor-α Inhibitor Treatment in Patients with Rheumatoid Arthritis / 中国医科大学学报

ABSTRACT

Objective To investigate the predictive value of serum survivin for clinical efficacy of tumor necrosis factor-α (TNF-α) inhibitor treatment in rheumatoid arthritis (RA) patients. Methods This study enrolled 63 consecutive patients with moderate or severe RA who received TNF-α inhibitor via subcutaneous injection 2 times/week, 25 mg/dose, for 24 weeks. According to disease activity, patients were also administered a disease-modifying antirheumatic drug. Serum survivin level was measured by enzyme-linked immunosorbent assay. The Disease Activity Score 28 was assessed, and clinical response and clinical remission were investigated. Results After treatment, 41 patients had a clinical response and 22 had no response. Baseline serum survivin level was reduced in the responder group compared to that in the non-responder group (P = 0.004). Receiver operating characteristic curve analysis showed that survivin level had good predictive value for non-response to TNF-α inhibitor treatment in RA patients (area under the curve:0.717, 95％ confidence interval:0.583-0.852). High survivin level (≥672.75 pg/mL) was an independent predictor of non-response to TNF-α inhibitor treatment in RA patients (P = 0.011), while a high C-reactive protein (CRP) level was an independent predictor of a better response to TNF-α inhibitor treatment (P = 0.011). High survivin level predicted non-response to TNF-α inhibitor treatment, independent of CRP level. However, baseline survivin level showed no difference between remission (16 cases) and non-remission groups (47 cases) (P = 0.265). A high survivin level did not affect remission in RA patients after TNF-α inhibitor treatment. Conclusion Baseline serum survivin level can predict the response of RA patients to TNF-α inhibitor treatment.