High Survivin Levels Predict Poor Clinical Response to Infliximab Treatment in Patients with Rheumatoid Arthritis

Research output: Contribution to journalReview article


Objective: To evaluate if the measurement of survivin in the blood of patients with rheumatoid arthritis (RA) undergoing infliximab treatment has predictive value for treatment response. Methods: The study included 87 consecutive RA patients (age 24-89 years, disease duration 18-526 months) treated with regular infusions of influximab. Survivin levels were measured by enzyme-linked immunosorbent assay and evaluated in relation to the total dose of infliximab, disease activity (DAS28), response to infliximab treatment (change in DAS28 > 1.2), and radiographic damage (vdH-Sharp score). Results: Thirty-seven percent of patients were survivin-positive (survivin > 0.9 ng/mL) and showed severe radiographic damage at the start of infliximab treatment compared with survivin-negative (P = 0.027). Patients with high survivin levels were unlikely to respond to infliximab treatment (OR 4.02 [1.22-14.61], P = 0.022) and achieve remission (OR 4.32[1.01-30.11], P = 0.048) compared with patients with low survivin levels. Conclusions: High survivin levels are associated with severe radiographic damage at the start of treatment and a poor response to infliximab. Survivin measurement should be considered an additional tool for aiding the selection and follow-up of antirheumatic treatment. (C) 2012 Elsevier Inc. All rights reserved. Semin Arthritis Rheum 41:652-657


  • Anniella Isgren
  • Kristina Forslind
  • Malin Erlandsson
  • Carl Axelsson
  • Sofia Andersson
  • Anneli Lund
  • Maria Bokarewa
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Rheumatology and Autoimmunity


  • rheumatoid arthritis, infliximab, surviving, treatment
Original languageEnglish
Pages (from-to)652-657
JournalSeminars in Arthritis and Rheumatism
Issue number5
Publication statusPublished - 2012
Publication categoryResearch