Assessing serological inflammation is difficult in tocilizumab (TCZ)-treated rheumatoid arthritis (RA) patients, as standard inflammation parameters, like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), are influenced by interleukin-6-receptor inhibition. Calprotectin in the serum, also named S100A8/S100A9, might be a more useful inflammation parameter in TCZ-treated patients. Sixty-nine RA patients taking TCZ were included. Serum-calprotectin levels were assessed, as well as ESR, CRP, need for a change in disease-modifying anti-rheumatic drugs due to RA activity (= active RA), and the RA clinical disease activity score (CDAI). Forty-five RA patients taking tumor-necrosis factor-inhibitors (TNFi) were investigated for the same parameters. TCZ-treated patients with active RA had higher calprotectin values than not active RA patients (4155.5 [inter quartile range 1865.3–6068.3] vs 1040.0 [676.0–1638.0] ng/ml, P < 0.001). A calprotectin cut-off value of 1916.5 ng/ml resulted in a sensitivity and specificity of 80.0 %, respectively, for the detection of RA disease activity. Calprotectin values correlated with CDAI-scores (r = 0.228; P = 0.011). ESR and CRP were less suitable to detect RA activity in TCZ-treated patients. Also TNFi-treated patients with active RA had higher calprotectin values compared to not active RA (5422.0 [3749.0–8150.8] vs 1845.0 [832.0–2569.0] ng/ml, P < 0.001). The calprotectin value with the best sensitivity and specificity for detecting RA activity was 3690.5 ng/ml among TNFi-treated patients. Calprotectin in the serum can be a useful inflammation parameter despite TCZ-treatment.

中文翻译：

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钙卫蛋白 (S100A8/S100A9) 检测接受托珠单抗治疗的类风湿关节炎患者的炎症活动

评估托珠单抗 (TCZ) 治疗的类风湿性关节炎 (RA) 患者的血清炎症是很困难的，因为标准炎症参数，如红细胞沉降率 (ESR) 和 C 反应蛋白 (CRP)，受到白细胞介素 6 受体抑制的影响。血清中的钙卫蛋白，也称为 S100A8/S100A9，可能是 TCZ 治疗患者更有用的炎症参数。包括 69 名服用 TCZ 的 RA 患者。评估了血清钙卫蛋白水平，以及 ESR、CRP、因 RA 活动（= 活动性 RA）而改变疾病缓解抗风湿药物的需要，以及 RA 临床疾病活动评分（CDAI）。研究了 45 名服用肿瘤坏死因子抑制剂 (TNFi) 的 RA 患者的相同参数。TCZ 治疗的活动性 RA 患者的钙卫蛋白值高于非活动性 RA 患者（4155.5 [四分位间距 1865.3-6068.3] vs 1040.0 [676.0-1638.0] ng/ml，P < 0.001）。1916.5 ng/ml 的钙卫蛋白临界值导致检测 RA 疾病活动的灵敏度和特异性分别为 80.0%。钙卫蛋白值与 CDAI 评分相关（r = 0.228；P = 0.011）。ESR 和 CRP 不太适合检测 TCZ 治疗患者的 RA 活性。此外，与非活动性 RA 相比，接受 TNFi 治疗的活动性 RA 患者的钙卫蛋白值更高（5422.0 [3749.0–8150.8] vs 1845.0 [832.0–2569.0] ng/ml，P < 0.001）。在 TNFi 治疗的患者中，检测 RA 活性的灵敏度和特异性最好的钙卫蛋白值为 3690.5 ng/ml。