Early increase in serum-COMP is associated with joint damage progression over the first five years in patients with rheumatoid arthritis

BMC Musculoskeletal Disorders

Tore Saxne³  Dick Heinegård³  Kristina Forslind²  Kristina Albertsson⁴  Ingiäld Hafström⁴  Ingemar F Petersson³  Björn Svensson³  Maria L E Andersson¹ 

[1] R and D center, Spenshult Hospital, Oskarström, Sweden;Section of Rheumatology, Department of Internal medicine Helsingborgs Lasarett, Helsingborgs Lasarett, Helsingborg, Sweden;Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden;Department of Rheumatology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden

关键词: Radiographic joint damage progression;    Biomarkers;    Rheumatoid arthritis;    COMP;    Cartilage oligomeric matrix protein;   

Others  :  1130076
DOI  :  10.1186/1471-2474-14-229

 received in 2013-02-05, accepted in 2013-07-29,  发布年份 2013

【 摘 要 】

Background

Currently available biomarkers for the early tissue process leading to joint damage in rheumatoid arthritis are insufficient and lack prognostic accuracy, possibly a result of variable activity of the disease over time. This study represents a novel approach to detect an altered activity of the disease process detected as increasing serum-COMP levels over a short time and whether this would correlate with joint damage progression over the first 5 years of disease.

Methods

In all, 349 patients from the Swedish BARFOT early RA study were examined. Serum-COMP was analysed by ELISA at diagnosis and after 3 months. Based on changes in serum-COMP levels, three subgroups of patients were defined: those with unchanged levels (change ≤ 20%) (N=142), decreasing levels (> 20%) (N=173) and increasing levels (> 20%) (N=34). Radiographs of hands and feet were obtained at inclusion, after 1, 2 and 5 years and scored according to Sharp van der Heijde (SHS). Radiographic progression was defined as increase in SHS by ≥5.8.

Results

The group of patients with increasing COMP levels showed higher median change in total SHS and erosion scores at 1, 2 and 5 year follow-up compared with the groups with stable or decreasing COMP levels. Furthermore, the odds ratio of radiographic progression was 2.8 (95% CI 1.26-6.38) for patients with increasing COMP levels vs. patients with unchanged levels.

The group of patients with increasing COMP levels had higher ESR at inclusion but there were no baseline differences between the groups for age, gender, disease duration, disease activity (DAS28), function (HAQ), CRP, nor presence of rheumatoid factor or anti-CCP. Importantly, neither did changes over the 3-month period in DAS28, HAQ, ESR nor CRP differ between the groups and these variables did not correlate to joint damage progression.

Conclusion

Increasing serum-COMP levels between diagnosis and the subsequent 3 months in patients with early RA represents a novel indicator of an activated destructive process in the joint and is a promising tool to identify patients with significant joint damage progression during a 5-year period.

【 授权许可】

   
2013 Andersson et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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