Serum Matrix Metalloproteinase-3 as Predictor of Joint Destruction in Rheumatoid Arthritis, Treated with Non-biological Disease Modifying Anti-rheumatic Drugs

摘要

Background: Rheumatoid factor (RF), anti-citrullinated peptide antibody (ACPA),C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) have been studiedextensively as prognostic markers of rheumatoid arthritis (RA). However, despite thefact that matrix metalloproteinase-3 (MMP-3) is linked to RA activity, few studies haveevaluated MMP-3 as prognostic marker.Objective: To evaluate the performance of MMP-3 as predictor of joint destructionin RA treated with non-biological disease modifying anti-rheumatic drugs.Methods: In a retrospective study of 58 early to moderate stage RA patients whoconsulted the Department of Clinical Pathology and Immunology, Kobe UniversityHospital between May 2002 and April 2009, we evaluated the performance of MMP-3and other biomarkers as predictors of joint destruction, by comparing them betweenradiographically progressive and non-progressive group.Results: Serum levels of RF at entry and ACPA, but not MMP-3 at entry, weresignificantly higher for the progressive group. Ratios of patients with MMP-3 levelshigher than healthy control were not significantly different for the two groups.However, cutoff values determined through receiver operating characteristic analysisshowed that the ratio of patients with elevated RF was significantly higher in theprogressive group (p=0.001), while MMP-3 (p=0.092), ACPA (p=0.052), CRP (p=0.056),and ESR (p=0.069) tended to be more elevated in the progressive group. Multiplelogistic regression analysis using the cutoff value identified MMP-3 positive and RFpositive, but not ACPA, CRP or ESR, as significant factors for radiographicprogression (OR 16.79 [95% CI: 1.34-414.19]).Conclusion: MMP-3 can be a useful marker for prediction of joint destruction.??