Yosuke Hattori1, Toshihisa Kojima2, Atsushi Kaneko1, Daihei Kida1, Yuji Hirano3, Takayoshi Fujibayashi4, Yuichiro Yabe5, Takeshi Oguchi6, Yasuhide Kanayama7, Hiroyuki Miyake8, Takefumi Kato9, Hideki Takagi10, Masatoshi Hayashi11, Takayasu Ito12, Tomone Shioura13, Nobunori Takahashi2, Hisato Ishikawa14, Koji Funahashi15, Naoki Ishiguro2. 1. a Department of Orthopaedic Surgery and Rheumatology , National Hospital Organization Nagoya Medical Center , Nagoya , Japan. 2. b Department of Orthopaedic Surgery , Nagoya University Graduate School of Medicine , Nagoya , Japan. 3. c Department of Rheumatology , Toyohashi Municipal Hospital , Toyohashi , Japan. 4. d Department of Orthopaedic Surgery , Konan Kosei Hospital , Konan , Japan. 5. e Department of Rheumatology , Japan Community Healthcare Organization Tokyo Shinjuku Medical Center , Tokyo , Japan. 6. f Department of Orthopaedic Surgery , Anjo Kosei Hospital , Anjo , Japan. 7. g Department of Orthopedic Surgery and Rheumatology , Toyota Kosei Hospital , Toyota , Japan. 8. h Department of Orthopaedic Surgery , Ichinomiya Municipal Hospital , Ichinomiya , Japan. 9. i Kato Clinic , Okazaki , Japan. 10. j Department of Orthopaedic Surgery , Nagoya Central Hospital , Nagoya , Japan. 11. k Department of Rheumatology , Nagano Red Cross Hospital , Nagano , Japan. 12. l Ito Seikeigeka , Nagoya , Japan. 13. m Shizuoka Kosei Hospital , Shizuoka , Japan. 14. n Department of Orthopaedic Surgery , Japanese Red Cross Nagoya Daiichi Hospital , Nagoya , Japan. 15. o Department of Orthopaedic Surgery , Kariya Toyota General Hospital , Kariya , Japan.
Abstract
OBJECTIVE: This study aimed to determine whether serum matrix metalloproteinase-3 (MMP-3) levels can predict remission in rheumatoid arthritis (RA) patients treated with adalimumab (ADA). METHODS: Subjects were 114 RA patients continuously treated with ADA for 52 weeks. Predictive factors at baseline and 4 weeks after initiation of ADA therapy for the achievement of remission (28-point count Disease Activity Score-CRP (DAS28-CRP) < 2.3) at 52 weeks were evaluated by multivariate logistic regression analysis. RESULTS: DAS28-CRP at 4 weeks (odds ratio (OR) 0.614, 95% confidence interval (CI) 0.382-0.988) and improvement in serum MMP-3 levels at 4 weeks (OR 1.057, 95% CI 1.002-1.032) were independent predictors of remission at 52 weeks. The best cut-off level of DAS28-CRP and improvement in serum MMP-3 levels at 4 weeks for predicting remission at 52 weeks was 3.73 (sensitivity: 90%, specificity: 50%, area under the receiver operating characteristic curve (AUC): 62%) and 39.93% (sensitivity: 47%, specificity: 83%, AUC: 64%), respectively. CONCLUSION: Our findings suggest that a high rate of improvement in serum MMP-3 levels at 4 weeks after initiation of ADA therapy can predict remission at 52 weeks in RA patients.
OBJECTIVE: This study aimed to determine whether serum matrix metalloproteinase-3 (MMP-3) levels can predict remission in rheumatoid arthritis (RA) patients treated with adalimumab (ADA). METHODS: Subjects were 114 RApatients continuously treated with ADA for 52 weeks. Predictive factors at baseline and 4 weeks after initiation of ADA therapy for the achievement of remission (28-point count Disease Activity Score-CRP (DAS28-CRP) < 2.3) at 52 weeks were evaluated by multivariate logistic regression analysis. RESULTS: DAS28-CRP at 4 weeks (odds ratio (OR) 0.614, 95% confidence interval (CI) 0.382-0.988) and improvement in serum MMP-3 levels at 4 weeks (OR 1.057, 95% CI 1.002-1.032) were independent predictors of remission at 52 weeks. The best cut-off level of DAS28-CRP and improvement in serum MMP-3 levels at 4 weeks for predicting remission at 52 weeks was 3.73 (sensitivity: 90%, specificity: 50%, area under the receiver operating characteristic curve (AUC): 62%) and 39.93% (sensitivity: 47%, specificity: 83%, AUC: 64%), respectively. CONCLUSION: Our findings suggest that a high rate of improvement in serum MMP-3 levels at 4 weeks after initiation of ADA therapy can predict remission at 52 weeks in RApatients.