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The current study was undertaken to investigate whether baseline serum levels of the chemokine CXCL13 might predict clinical and ultrasonographic (US) outcomes in patients with recent-onset RA.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>The study included 161 early RA patients (disease duration &lt; 12 months) treated according to a disease activity score (DAS) driven step-up protocol aiming at DAS &lt; 2.4. Clinical disease activity measures were collected at baseline, 2, 4, 6, 9 and 12 months, and US examination of the hands was performed at baseline, 6 and 12 months. Grey-Scale (GS) and Power Doppler (PD) synovitis were scored (0 to 3), with overall scores as the sum of each joint score. CXCL13 levels were measured at baseline by enzyme-linked immunosorbent assay and evaluated in relation to the achievement of low disease activity (LDA, DAS &lt; 2.4) and US residual inflammation (PD \u2264 1) at 12 months.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Baseline levels of CXCL13 were significantly higher in RA compared to healthy controls (<jats:italic>n<\/jats:italic> = 19) (<jats:italic>P<\/jats:italic> = 0.03) and correlated with measures of synovitis, such as the swollen joint count (R 0.28, <jats:italic>P<\/jats:italic> &lt; 0.001), the US-GS (R 0.27, <jats:italic>P<\/jats:italic> = 0.003) and US-PD (R 0.26, <jats:italic>P<\/jats:italic> = 0.005) score. Although CXCL13 did not predict the likelihood of achieving clinical LDA at 12 months within a structured treat-to-target protocol, elevated levels of CXCL13 were associated with more frequent increases of methotrexate dosage (<jats:italic>P<\/jats:italic> &lt; 0.001). Using adjusted analyses, the highest levels of CXCL13 (&gt; 100 pg\/ml) were the only independent predictor of residual imaging inflammation (<jats:italic>P<\/jats:italic> = 0.005), irrespective of initial US-PD scores, disease activity status, acute phase reactants and autoantibodies. Among the patients in clinical LDA at 12 months, US-PD scores \u2264 1 were less frequently achieved in the high baseline CXCL13 (&gt; 100 pg\/ml) group, with an adjusted OR = 0.06 (95% CI 0.01 to 0.55, <jats:italic>P<\/jats:italic> = 0.01).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>CXCL13 emerges as a new biological marker in early RA, accurate in assessing the severity of synovitis and the persistence of US-PD activity over time in response to conventional treatments.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/ar3742","type":"journal-article","created":{"date-parts":[[2012,2,15]],"date-time":"2012-02-15T15:17:55Z","timestamp":1329319075000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Serum levels of CXCL13 are associated with ultrasonographic synovitis and predict power Doppler persistence in early rheumatoid arthritis treated with non-biological disease-modifying anti-rheumatic drugs"],"prefix":"10.1186","volume":"14","author":[{"given":"Serena","family":"Bugatti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Manzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Benaglio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Klersy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Vitolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Todoerti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garifallia","family":"Sakellariou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlomaurizio","family":"Montecucco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Caporali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2012,2,15]]},"reference":[{"key":"3526_CR1","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1136\/ard.2009.126748","volume":"69","author":"R Knevel","year":"2010","unstructured":"Knevel R, Schoels M, Huizinga TW, Aletaha D, Burmester GR, Combe B, Landew\u00e9 RB, Smolen JS, Sokka T, van der Heijde DM: Current evidence for a strategic approach to the management of rheumatoid arthritis with disease-modifying antirheumatic drugs: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. 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