6-beta-hydroxycortisol and Arthritis--Rheumatoid

Topics: Adrenal Cortex; Adult; Amniotic Fluid; Animals; Arthritis, Rheumatoid; Cushing Syndrome; Depression; Female; Humans; Hydrocephalus; Hydrocortisone; Hydroxylation; Infant, Newborn; Infant, Premature; Liver Cirrhosis; Male; Meningomyelocele; Methods; Neoplasms; Pregnancy; Pregnancy Complications; Steroid Hydroxylases; Thyroid Diseases; Tissue Distribution

The objective was to analyse whether the activity of the cytochrome P450 isoenzyme CYP3A4 is altered by disease activity of rheumatoid arthritis (RA). Urinary 6 beta-hydroxycortisol excretion, expressed as a fraction of the urinary creatinine output, was measured in 21 patients with RA treated with three different disease-modifying anti-rheumatic drugs (DMARDs) over 24 weeks. There were no correlations between urinary 6 beta-hydroxycortisol/creatinine (6 beta-OHC/Creat) ratio and measurements of disease activity such as plasma viscosity, Ritchie articular index and early morning stiffness. In addition, the three DMARDs sulphasalazine, sodium aurothiomalate and D-penicillamine, smoking and the intake of various CYP3A4 substrates had no consistent detectable effect on the 6 beta-OHC/Creat ratio. There is no evidence that the dosage of drugs metabolized by the CYP3A4 isoenzyme needs to be adjusted for disease activity in RA.

Topics: Adult; Aged; Antirheumatic Agents; Arthritis, Rheumatoid; Energy Metabolism; Female; Gold Sodium Thiomalate; Humans; Hydrocortisone; Male; Penicillamine; Sulfasalazine