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Only RF positivity was higher in the IL-17A high group (Table 1). At baseline, TNF-��, IL-21, and IL-23 levels were significantly higher in the IL-17A high group than in the IL-17A low group (P = 0.001, P = 0.003, and P = 0.002, resp.). Levels of IL-6 and sIL-6R at baseline were not significantly different between the groups (Table 2). Figure 2 Bimodal distribution of IL-17A levels in the patients. Upper normal PF-02341066 chemical structure value of IL-17A level was defined as the mean serum IL-17A levels + 3SD in healthy controls (n = 12). IL-17A levels of RA patients were divided into INCB018424 nmr the IL-17A low (n = 21) and high ( ... Table 2 Comparison of?baseline serum cytokine levels in the IL-17A low group and the IL-17A high group. 3.4. Low Baseline Levels of IL-17A Were Associated with Better Clinical Response to TCZ Treatment A significantly higher proportion of patients in the IL-17A low group achieved DAS28 ESR remission at 12 weeks as compared to the IL-17A high group (47.6 versus 17.4%; P = 0.032 by Fisher's exact test) (Figure 3(a)). Individual DAS28 ESR scores in each group at baseline and 12 weeks are depicted in Figure 3(b). In the IL-17A low group, the mean DAS28 score improved from 6.07 �� 0.20 at baseline to 2.93 �� 0.25 at 12 weeks, whereas the mean DAS28 score in the IL-17A high group declined from 6.16 �� 0.14 to 3.49 �� 0.21. The improvement in the DAS28 ESR was significantly better in the IL-17A low group compared to the IL-17A high group at 12 weeks (3.15 �� 0.21 versus 2.66 �� 0.17; P = 0.045) after adjusting for baseline DAS28 ESR, RF positivity, and levels of TNF-��, IL-21, and IL-23. After 12 weeks, 18 (85.7%) of 21 patients in the IL-17A low group and 21 (91.3%) of 23 patients in the IL-17A high group AZ191 continued the therapy with TCZ over a period of 24 weeks. TCZ was discontinued in five patients due to adverse effects. At 24 weeks, the mean DAS28 ESR score in the IL-17A low and high groups was 2.57 �� 0.21 and 3.10 �� 0.22, respectively. DAS28 ESR improved from baseline significantly more in the IL-17A low group compared to the IL-17A high group at 24 weeks (3.47 �� 0.23 versus 2.99 �� 0.22; P = 0.046) as well (Figure 3(c)). Figure 3 Low baseline levels of IL-17A are associated with DAS28 ESR remission at 12 weeks of tocilizumab treatment. A significantly higher proportion of patients in the IL-17A low group achieved DAS28 remission at 12 weeks as compared to the IL-17A high group ... 3.5. Effect of TCZ on the Levels of Th17-Related Cytokines after Treatment Levels of IL-6 and IL-17A did not significantly change during treatment. However, levels of IL-21 and IL-23 were decreased significantly at 12 weeks in both DAS28 remission and nonremission patients (all P
