Serum sclerostin and Dickkopf-related protein 1 levels of axial spondyloarthritis can be raised by selective cyclo-oxygenase 2 inhibitor

Abstract

Objective To investigate the serum levels of dickkopf-related protein 1 (DKK1) and sclerostin (SOST) in patients with axial spondyloarthritis treated with selective cyclo-oxygenase 2 inhibitor and its relation to clinical efficacy. Methods A randomized double-blind controlled trial with axial spondyloar-thritis (ax-SpA) was carried out in our hospital. The data from patients in a single center was collected and analyzed. Serum DKK1 and SOST levels were measured by enzyme-linked immuno sorbent assay (ELISA) method before and after 12 weeks treatment, then correlation analysis were conducted for DKK1 and SOST levels with erythrocyte sedimentation rate (ESR), C reactive protein (CRP), Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI) and SPARCC of the sacroiliac joint inflammation score. Chi-square tests were used for analyzing of categorical data. Fisher exact tests were performed when the expected frequencies were less than 5. Two independent samples t-test was used to com-pare the difference between groups. Single sample t-test was used to ompare the differences between data before and after treatment. Pearson or Spearman correlation was used for correlation analysis. Results After 12 weeks of treatment, a total of 116 patients completed the follow-up, including 57 cases of imrecoxib group and 59 cases of the celecoxib group. There were no statistically significant difference between the two groups (P>0.05). The level of serum DKK1 was significantly increased after treatment [(393±137) pg/ml, vs (542±274) pg/ml,P 0.05], too. The difference between the two groups was not statistically significant (P>0.05). Spearman cor-relation analysis showed that serum DKK1 was positively correlated with serum SOST (r=0.226, P=0.015). A significantcorrelation was found between SOST level and ESR, CRP, finger to floor distance, left and right lumbar side flexion and Schober's test (ESR: r=-0.379, P<0.01; r=-0.309, P=0.001; r=-0.225, P=0.015; r=0.185, P=0.047; r=0.247, P=0.008; r=0.214, P=0.021). Conclusion Imrecoxib and celecoxib have similar efficacy on relieving the signs and symptoms of patients with ax-SpA. Short-term application of selective COX-2 inhibitors can increase DKK1 and SOST and possibly delay radiographic progression. Key words: Osteoarthritis, spine; Cyclooxygenase 2 inhibitors; Dickkopf-related protein 1; Sclerostin