Serum amyloid protein A concentration in cryopyrin-associated periodic syndrome patients treated with interleukin-1 beta antagonist

Serena Pastore, Giulia Paloni, Roberta Caorsi, Luca Ronfani, Andrea Taddio, L. Lepore, Maria Alessio, Luca Cantarini, Marco Cattalini, Rita Consolini, Marco Gattorno, Valeria Gerloni, Antonella Insalaco, Giorgia Martini, Silvana Martino, Laura Obici, Donato Rigante

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Cryopyrin-associated periodic syndromes (CAPS) are a group of chronic, relapsing autoinflammatory disorders which may be complicated by systemic AA amyloidosis. The aim of our study was to evaluate serum amyloid protein A (SAA) level in CAPS patients treated with Interleukin-1 beta (IL-1β) antagonist and to correlate its level with treatment response. Methods: All patients of CAPS Italian Register treated with IL-1β inhibitor were enrolled. SAA levels before starting therapy, and at last visit were evaluated. Patients were then divided in complete responders and partial responders. Results: Twenty-five patients were enrolled. SAA level before starting therapy was increased (median 118.5 mg/L, IQR 96.4-252.8; normal value <6.4 mg/L), while at last visit SAA was significantly reduced (median 4.3 mg/L, IQR 2.3-12.7) (p <0.001). However 12 patients still presented SAA levels beyond normal range, 10/25 patients (40%) showed a complete response to treatment. Conversely, 15 patients presented only a partial response, of which 12 for increased SAA value and 3 for increased CRP value. Patients with partial response had SAA values significantly higher than patients with complete response (median 12.6 mg/L; IQR 8.3-20.0 vs. 2.7 mg/L; IQR 1.6-4.1, p <0.001). Conclusion: Our results confirm the long term efficacy of anti IL-1β treatment in CAPS and the decrease of SAA levels; however 48% of patients still presented SAA elevation despite treatment. The real risk of these patients in developing amyloidosis is not clear but the persistent increase of SAA needs a close follow-up.

Original languageEnglish
Pages (from-to)S63-S66
JournalClinical and Experimental Rheumatology
Volume32
Publication statusPublished - 2014

Keywords

  • Amyloidosis
  • Cryopyrin-associated periodic syndromes
  • IL-1β inhibitor
  • Inflammation
  • Serum amyloid protein A

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy
  • Medicine(all)

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