The impact of therapies as monotherapy with combined therapy on novel and traditional biomarkers in patients with rheumatoid arthritis

Abstract

Background and objectives: Rheumatoid arthritis is an autoimmune and inflammatory disease that influences many tissues and organs. Inflammatory markers such as C-reactive protein, erythrocyte sedimentation rate, anti-cyclic citrullinated protein, rheumatoid factor, and 14-3-3η protein have been found to play an important role in both the diagnosis and progression of rheumatoid arthritis. This study aimed to elucidate the effect of anti-rheumatoid medication, as mono- and combined therapy, on these inflammatory mediators. Methods: A cross-sectional study was performed at Hawler Medical University, College of Pharmacy, Erbil, Iraq. Forty-two patients of both genders with rheumatoid arthritis participated in the study as group I. Forty-four age–gender matched adults (with no rheumatoid arthritis) were included as a comparison group or group II. Serum levels of biomarkers were determined by enzyme linked immune sorbent assay. Results: There was a statistically significant (P <0.05) increased level of serum anti-cyclic citrullinated peptide, 14-3-3η protein, erythrocyte sedimentation rate, C-reactive protein, and rheumatic factor levels in group I compared with group II. The serum level of the anti-cyclic citrullinated peptide significantly decreased in rheumatoid patients treated with combined therapy compared with mono remedy. However, the mean of body mass index, age, and gender of group I was non-significantly different from group II (P >0.05). Conclusion: Therapeutic regimen of mono or combined therapy played a role in changing levels of inflammatory markers. Anti-cyclic citrullinated protein significantly decreased with the combined therapy in comparison with the monotherapy regimen. Keywords: Rheumatic arthritis; Monotherapy; Combined therapy; Anti-rheumatoid; Inflammatory markers.