In a nutshell
The aim of this study was to investigate the effectiveness of cetrorelix in rheumatoid arthritis (RA) patients with high gonadotropin hormone levels.
Some background
Gonadotropin-releasing hormone (GnRH) is a combination of several hormones that are responsible for regulating normal growth, sexual development and reproductive functions. These hormones also cause inflammation. During menopausal transition or post-childbirth, when GnRH levels are elevated, RA symptoms may develop or increase due to the inflammatory effect of GnRH. Therefore, substances which can stop the GnRH-mediated inflammation (GnRH antagonists) may be effective treatments in RA. Cetrorelix (Cetrotide) is an example of a GnRH antagonist.
The effect of cetrorelix in RA patients with high levels of GnRH needs to be investigated to establish the utility of this class of drugs in RA.
Methods & findings
The authors aimed to evaluate the effectiveness and safety of cetrorelix in female RA patients with high levels of GnRH.
Data from 53 patients with high levels of GnRH were analyzed in this study. 27 patients in group 1 were randomly assigned to receive cetrorelix. 26 patients in group 2 were randomly assigned to receive placebo (substance with no effect on the body). Both placebo and cetrorelix were administered by injection in the skin. The DAS28-CRP score was measured over 5 days. DAS28 (Disease Activity Score) is an assessment to measure the progress and improvement of RA by examining 28 joints. CRP (C-reactive protein) is a protein in blood, which is increased when inflammation is present. The lower the DAS28-CRP score, the better was the improvement.
The average DAS28-CRP score decreased by 1.0 for group 1 patients. It decreased by 0.4 for group 2 patients. By day 5, 44% of patients in group 1 achieved 20% improvement according to ACR (American College of Rheumatology, another measure of disease activity) criteria. This was compared to 19% of patients in group 2. By day 15, patients in group 1 achieved overall reduction in blood levels of several proteins that contribute to inflammation. Treatment-related adverse events such as headache, nausea and discomfort at injection site were mild and affected both groups equally.
The bottom line
The authors concluded that cetrorelix reduced inflammation in RA patients with high gonadotropin levels.
The fine print
A larger patient population and a longer follow-up time are needed for the results to be widely applied.
Published By :
PLOS ONE
Date :
Oct 13, 2015
