Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy

Rainer H. Straub, Peter Härle, Fabiola Atzeni, Claudia Weidler, Maurizio Cutolo, Piercarlo Sarzi-Puttini

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective. Androgens such as dehydroepiandrosterone sulfate (DHEAS) and testosterone are markedly lower in postmenopausal women with rheumatoid arthritis (RA) than in controls. In contrast, compared to controls, serum levels of estrogens are normal or elevated in women with RA. Since tumor necrosis factor (TNF) alters production of these hormones, we investigated changes of these hormones during anti-TNF antibody (anti-TNF) therapy with adalimumab in longstanding RA. Methods. In this longitudinal anti-TNF therapy study in 13 patients with long-standing RA without prior prednisolone (7 infusions of anti-TNF: Week 0, 2, 4, 6, 8, 10, and 12), we measured serum concentrations of interleukin 6 (IL-6), androstenedione, DHEA, DHEAS, free testosterone, estrone, and 17β-estradiol. Levels of these hormones in patients were compared to serum levels of 31 age and sex matched healthy controls. Results. Upon treatment with anti-TNF, there was an impressive decrease of clinical markers of inflammation, erythrocyte sedimentation rate, and serum levels of IL-6. Serum levels of DHEAS and free testosterone were markedly lower at baseline in patients compared to controls, but this did not change during anti-TNF therapy. Serum levels of DHEA and 17β-estradiol were significantly elevated in patients compared to controls, but similarly, anti-TNF therapy did not change initially increased levels. Molar ratios of hormones, which reflect hormone shifts via converting enzymes, showed typical alterations at baseline, but did not change markedly during anti-TNF therapy. Conclusion. Longterm therapy with anti-TNF did not change altered serum levels of typical sex hormones in patients with RA, although baseline values were largely different. In patients with RA, this indicates that alterations of sex hormones and altered activity of respective converting enzymes are imprinted for a long-lasting period over at least 12 weeks.

Original languageEnglish
Pages (from-to)1253-1257
Number of pages5
JournalJournal of Rheumatology
Volume32
Issue number7
Publication statusPublished - Jul 2005

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Gonadal Steroid Hormones
Rheumatoid Arthritis
Tumor Necrosis Factor-alpha
Dehydroepiandrosterone Sulfate
Hormones
Serum
Therapeutics
Testosterone
Estradiol
Interleukin-6
Dehydroepiandrosterone
Androstenedione
Estrone
Blood Sedimentation
Enzymes
Prednisolone
Androgens
Anti-Idiotypic Antibodies
Estrogens
Biomarkers

Keywords

  • Adalimumab
  • Androgen
  • Estrogen
  • Rheumatoid arthritis
  • Sex hormones
  • Tumor necrosis factor

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Straub, R. H., Härle, P., Atzeni, F., Weidler, C., Cutolo, M., & Sarzi-Puttini, P. (2005). Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy. Journal of Rheumatology, 32(7), 1253-1257.

Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy. / Straub, Rainer H.; Härle, Peter; Atzeni, Fabiola; Weidler, Claudia; Cutolo, Maurizio; Sarzi-Puttini, Piercarlo.

In: Journal of Rheumatology, Vol. 32, No. 7, 07.2005, p. 1253-1257.

Research output: Contribution to journalArticle

Straub, RH, Härle, P, Atzeni, F, Weidler, C, Cutolo, M & Sarzi-Puttini, P 2005, 'Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy', Journal of Rheumatology, vol. 32, no. 7, pp. 1253-1257.
Straub, Rainer H. ; Härle, Peter ; Atzeni, Fabiola ; Weidler, Claudia ; Cutolo, Maurizio ; Sarzi-Puttini, Piercarlo. / Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy. In: Journal of Rheumatology. 2005 ; Vol. 32, No. 7. pp. 1253-1257.
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abstract = "Objective. Androgens such as dehydroepiandrosterone sulfate (DHEAS) and testosterone are markedly lower in postmenopausal women with rheumatoid arthritis (RA) than in controls. In contrast, compared to controls, serum levels of estrogens are normal or elevated in women with RA. Since tumor necrosis factor (TNF) alters production of these hormones, we investigated changes of these hormones during anti-TNF antibody (anti-TNF) therapy with adalimumab in longstanding RA. Methods. In this longitudinal anti-TNF therapy study in 13 patients with long-standing RA without prior prednisolone (7 infusions of anti-TNF: Week 0, 2, 4, 6, 8, 10, and 12), we measured serum concentrations of interleukin 6 (IL-6), androstenedione, DHEA, DHEAS, free testosterone, estrone, and 17β-estradiol. Levels of these hormones in patients were compared to serum levels of 31 age and sex matched healthy controls. Results. Upon treatment with anti-TNF, there was an impressive decrease of clinical markers of inflammation, erythrocyte sedimentation rate, and serum levels of IL-6. Serum levels of DHEAS and free testosterone were markedly lower at baseline in patients compared to controls, but this did not change during anti-TNF therapy. Serum levels of DHEA and 17β-estradiol were significantly elevated in patients compared to controls, but similarly, anti-TNF therapy did not change initially increased levels. Molar ratios of hormones, which reflect hormone shifts via converting enzymes, showed typical alterations at baseline, but did not change markedly during anti-TNF therapy. Conclusion. Longterm therapy with anti-TNF did not change altered serum levels of typical sex hormones in patients with RA, although baseline values were largely different. In patients with RA, this indicates that alterations of sex hormones and altered activity of respective converting enzymes are imprinted for a long-lasting period over at least 12 weeks.",
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AB - Objective. Androgens such as dehydroepiandrosterone sulfate (DHEAS) and testosterone are markedly lower in postmenopausal women with rheumatoid arthritis (RA) than in controls. In contrast, compared to controls, serum levels of estrogens are normal or elevated in women with RA. Since tumor necrosis factor (TNF) alters production of these hormones, we investigated changes of these hormones during anti-TNF antibody (anti-TNF) therapy with adalimumab in longstanding RA. Methods. In this longitudinal anti-TNF therapy study in 13 patients with long-standing RA without prior prednisolone (7 infusions of anti-TNF: Week 0, 2, 4, 6, 8, 10, and 12), we measured serum concentrations of interleukin 6 (IL-6), androstenedione, DHEA, DHEAS, free testosterone, estrone, and 17β-estradiol. Levels of these hormones in patients were compared to serum levels of 31 age and sex matched healthy controls. Results. Upon treatment with anti-TNF, there was an impressive decrease of clinical markers of inflammation, erythrocyte sedimentation rate, and serum levels of IL-6. Serum levels of DHEAS and free testosterone were markedly lower at baseline in patients compared to controls, but this did not change during anti-TNF therapy. Serum levels of DHEA and 17β-estradiol were significantly elevated in patients compared to controls, but similarly, anti-TNF therapy did not change initially increased levels. Molar ratios of hormones, which reflect hormone shifts via converting enzymes, showed typical alterations at baseline, but did not change markedly during anti-TNF therapy. Conclusion. Longterm therapy with anti-TNF did not change altered serum levels of typical sex hormones in patients with RA, although baseline values were largely different. In patients with RA, this indicates that alterations of sex hormones and altered activity of respective converting enzymes are imprinted for a long-lasting period over at least 12 weeks.

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