MRP8/14 levels predict relapse in JIA

Elevated levels of myeloid related protein 8/14 (MRP8/14) predict an increased risk of relapse following withdrawal of methotrexate therapy in children with juvenile idiopathic arthritis with inactive disease status, according to a study presented at the Paediatric Rheumatology European Society congress. The PRINTO study randomised 364 JIA patients with inactive disease for at least 3 months to receive additional MTX for either 6 or 12 months. Serum sample analysis was conducted in 188 patients to track MRP8/14 levels at 3 month baseline, and again at either 6 or 12 months according to study protocol. Patients were followed-up for at least 12 months after MTX discontinuation. The researchers found that MRP8/14 levels were significantly higher at MTX withdrawal in remission in those patients who subsequently developed relapses (715±140 ng/ml) compared to patients with stable remission (400±105 ng/ml; p=0.003). Levels of MRP8/14 were especially high in patients with relapses occurring within 6 months, compared to 12 months (p<0.001). Lead author of the study Professor Dirk Foell from the University of Muenster, Germany, said the trial was the first to analyse the necessary time of treatment continuation once remission is achieved in a rheumatic disease. “Our study shows that patients with elevated levels of MRP 8/14 may specifically benefit from prolonged treatment and also that a longer duration of MTX therapy after achieving remission does not influence the risk of relapse on patients with JIA,” he said. “The results of our research help to make the case for the tracking of levels of biomarkers as predictors of treatment responses in this unique patient population,” Professor Foell concluded....