Abstract
Objective. Etanercept therapy effectively suppresses disease activity and improves symptoms of depression in patients with rheumatoid arthritis (RA). To elucidate the medication’s mechanism, changes in tumor necrosis factor (TNF)-α, interleukin (IL)-6 and dehydroepiandrosterone -salfate (DHEA-S) were examined.
Method. Self-rating Depression Scale (SDS), serum concentrations of TNFα, IL-6 and DHEA-S were assessed in 16 RA patients, at baseline and after 14 and 30 weeks of Etanercept treatment. Disease activity was evaluated with the disease activity score 28 (DAS28) ESR4. Quality of life was evaluated with the modified health assessment questionnaire (mHAQ).
Results. According to the EULAR improvement criteria of RA, patients were classified into two groups; the responsive group which has moderate-high response improvement and the no responsive group which has no response improvement. Total scores on the SDS and mHAQ were improved and the serum levels of IL-6 and DHEA-S also decreased in the patients in the moderate-high improvement group. On the other hand, there was no significant change in total scores on the SDS and mHAQ in the patients in the no improvement group. After treatment, there were no significant changes in serum levels of TNFα, IL-6 or DHEA-S.
Conclusion. Etanercept may improve depression in patients with RA by suppressing the expression of IL-6 and DHEA-S.
