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Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy.
J Rheumatol. 2005 Jul; 32(7):1253-8.JR

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 17ss-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 17ss-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.

Authors+Show Affiliations

Department of Internal Medicine I, Laboratory of Neuroendocrinoimmunology, University Medical Center, Regensburg, Germany. rainer.straub@klinik.uni-regensburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15996060

Citation

Straub, Rainer H., et al. "Sex Hormone Concentrations in Patients With Rheumatoid Arthritis Are Not Normalized During 12 Weeks of Anti-tumor Necrosis Factor Therapy." The Journal of Rheumatology, vol. 32, no. 7, 2005, pp. 1253-8.
Straub RH, Härle P, Atzeni F, et al. Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy. J Rheumatol. 2005;32(7):1253-8.
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. The Journal of Rheumatology, 32(7), 1253-8.
Straub RH, et al. Sex Hormone Concentrations in Patients With Rheumatoid Arthritis Are Not Normalized During 12 Weeks of Anti-tumor Necrosis Factor Therapy. J Rheumatol. 2005;32(7):1253-8. PubMed PMID: 15996060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sex hormone concentrations in patients with rheumatoid arthritis are not normalized during 12 weeks of anti-tumor necrosis factor therapy. AU - Straub,Rainer H, AU - Härle,Peter, AU - Atzeni,Fabiola, AU - Weidler,Claudia, AU - Cutolo,Maurizio, AU - Sarzi-Puttini,Piercarlo, PY - 2005/7/5/pubmed PY - 2005/8/24/medline PY - 2005/7/5/entrez SP - 1253 EP - 8 JF - The Journal of rheumatology JO - J Rheumatol VL - 32 IS - 7 N2 - 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 17ss-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 17ss-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. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/15996060/Sex_hormone_concentrations_in_patients_with_rheumatoid_arthritis_are_not_normalized_during_12_weeks_of_anti_tumor_necrosis_factor_therapy_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=15996060 DB - PRIME DP - Unbound Medicine ER -