Serum VEGF levels may have a role in the assessment of treatment response and disease activity during TNFi therapy in patients with axSpA.

OBJECTIVES

To evaluate the relationship between serum biomarkers [vascular endothelial growth factor (VEGF), matrix metalloproteinase-3, and leptin] and disease activity, and the changes in those biomarker levels during tumour necrosis factor inhibitor (TNFi) treatment in patients with axial spondyloarthritis (axSpA).

METHODS

Patients with axSpA initiating their first TNFi who had serum samples at baseline and the sixth month of therapy were included, and the relationship between these biomarkers and disease activity, and functional parameters was analysed.

RESULTS

A total of 74 axSpA patients [mean age (SD) 48.7 (12.8) years, 54.1% male] were included. Disease activity parameters (Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score-based C-reactive protein, and Bath Ankylosing Spondylitis Disease Functional Index) and C-reactive protein were significantly decreased at the sixth month of TNFi therapy (all P < .001). The correlation between biomarker levels and disease activity was evaluated, and only serum matrix metalloproteinase-3 levels were found to be associated with baseline Ankylosing Spondylitis Disease Activity Score-based C-reactive protein (P = .02). Serum VEGF levels decreased compared to the baseline at the sixth month (P < .001), however, serum leptin and matrix metalloproteinase-3 levels were not affected by TNFi (P = .50). Serum VEGF levels were substantially correlated with gender, hip involvement, delay in diagnosis, and disease activity in the longitudinal analysis.

CONCLUSIONS

In patients with axSpA, TNFi therapy significantly reduces serum VEGF levels and effectively reduces disease activity. VEGF has the potential to function as a dynamic biomarker that reflects the characteristics of the disease and the response to treatment.