Document Type : Original Article


1 Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Community and Preventive Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Medical Students Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Objective: Recently, adenosine deaminase (ADA) is introduced as helpful marker in 
diagnosis, prognosis, and monitoring of treatment in rheumatoid arthritis (RA). The aim 
of this study was to determine the efficacy of the serum ADA in diagnosis, prognosis, and 
monitoring of treatment with methotrexate (MTX) in RA.
Methods: This was a self‑controlled clinical trial conducted in university hospitals of 
Isfahan, Iran. The serum level of ADA, erythrocyte sedimentation rate (ESR), and rheumatoid 
factor(RF) were measured for 70 patients with active RA (Disease Activity Score-28 [DAS28] 
> 3/2). After three months of MTX treatment and disease remission (DAS28 < 2.6) these 
markers were measured again. ANCOVA multiregression and paired t‑test were used to 
compare and evaluate the mean level and correlation of ADA, ESR, IgM‑RF, and DAS before 
and after RA remission.
Findings: The mean value for ADA activity was significantly higher than the normal one 
compared with other studies. Significant decreases were seen in values of ADA, ESR, 
RF, visual analogue scale (VAS), and DAS after remission. Also, the correlation coefficient 
between the values of ADA with ESR and DAS were statistically significant in baseline. 
Moreover, the statistically significant correlation between ADA and ESR, VAS, and DAS 
were seen after remission. No correlation was found in the case of the dosage of MTX 
with the value of ADA.
Conclusion: It was concluded that ADA may be considered useful as a marker in diagnosis, 
prognosis, and monitoring of treatment with Methotrexate in RA.


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