Fibrinolytic activity in rheumatoid arthritis and the effects of prednisolone therapy

The relationship between disease activity and fibrinolytic activity was investigated in 40 patients with rheumatoid arthritis (RA). There was no difference in global fibrinolytic activity between RA and controls, 220 (200-330) and 280 (167-346) min respectively although inhibition of plasminogen activator activity (PAI) was lower in RA 8.2 (5.1-9.7) vs 9.9 (8.0-15.7) IU/ml than controls, p=0.01. There were no significant differences between RA and controls in tPA:Ag 4.8ng/ml (3.1-7.8) vs 7.1(5.2-9.3) or PAI-1:Ag 8.Ong-ml (4.8-10.8) vs 9.1 (3.6-22.3). 9 patients with severe RA received prednisolone 40 mg daily for 7 days. This improved disease activity clinically and was associated with a fall in fibrinogen from 4.4. g/l (3.4-5.2) to 2.32 (2.31-2.63), p<0.0005 and plasminogen from 117.6% (107-121) to 101.5 (88.7-110.4), p<0.005. In addition PAI-1:Ag increased from 5.4ng/ml (2.77-10.38) to 11.0 (4.45-16.65), p<0.005 and PAI from 8.51U/ml (6.49-8.99) to 10.1 (8.5-16.5), p<0.005. In this study PAI was lower in patients with RA. Prednisolone improved disease activity, reduced Fibrinogen and plasminogen and increased PAI and PAI-1:Ag. © 1993.