Effects of Adalimumab MTX Combination on Serum (NF-?B) and Caspase3 in Iraqi Patients with Rheumatoid Arthritis

Background Rheumatoid arthritis (RA) is a chronic inflammatory diseasewith variable degrees of bone and joints damage. Treatment with methotrexate (MTX) +/- biological agents such adalimumab (ADA), may produce dramatically changes in the progression and severity of RA which in turn affect expression of inflammatory pathway, inflammatory cytokines, NFB and caspases-3. Objective To assess effects of treatment by MTX and MTX-adalimumabon levels of inflammatory signaling. Subjects and methodsOpen label three groups prospective study on 100 Iraqi patients with RA plus 50 apparently healthy subjects, Patients were allocated to take MTX and MTX plus ADA. ResultsSerum (NF-B) Initially, was significantly elevated In RA groups of patients. Which in turn indicate the activation of this transcription factor. MTX-ADA treatment resulted in significant (NF-B) lowering as compared to MTX. Serumcaspases-3 in RA groups, initially were significantly lower than in normal subjects. After 3months of treatment, A significant elevation in caspases-3found in ADA+ MTX group as compared with initial value and MTX group. Conclusion Use of adalimumabMTX combination may result in lowering level of expression of serum NF-B used in regulation of inflammatory signaling and significant changes in caspase-3 level expressed in serum indicating increase cellular apoptosis.