Hattori Yosuke, Kojima Toshihisa, Kaneko Atsushi, Kida Daihei, Hirano Yuji, Fujibayashi Takayoshi, Yabe Yuichiro, Oguchi Takeshi, Kanayama Yasuhide, Miyake Hiroyuki, Kato Takefumi, Takagi Hideki, Hayashi Masatoshi, Ito Takayasu, Shioura Tomone, Takahashi Nobunori, Ishikawa Hisato, Funahashi Koji, Ishiguro Naoki
a Department of Orthopaedic Surgery and Rheumatology , National Hospital Organization Nagoya Medical Center , Nagoya , Japan.
b Department of Orthopaedic Surgery , Nagoya University Graduate School of Medicine , Nagoya , Japan.
Mod Rheumatol. 2018 Jan;28(1):119-125. doi: 10.1080/14397595.2017.1317320. Epub 2017 May 2.
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).
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.
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.
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.
本研究旨在确定血清基质金属蛋白酶-3（MMP-3）水平是否能够预测接受阿达木单抗（ADA）治疗的类风湿关节炎（RA）患者的病情缓解情况。
研究对象为114例连续接受ADA治疗52周的RA患者。通过多因素逻辑回归分析评估基线时以及ADA治疗开始后4周时对于52周时病情缓解（28关节疾病活动评分-红细胞沉降率（DAS28-CRP）＜2.3）的预测因素。
4周时的DAS28-CRP（比值比（OR）0.614，95%置信区间（CI）0.382-0.988）以及4周时血清MMP-3水平的改善情况（OR 1.057，95%CI 1.002-1.032）是52周时病情缓解的独立预测因素。预测52周时病情缓解的4周时DAS28-CRP和血清MMP-3水平改善情况的最佳截断值分别为3.73（敏感性：90%，特异性：50%，受试者工作特征曲线下面积（AUC）：62%）和39.93%（敏感性：47%，特异性：83%，AUC：64%）。
我们的研究结果表明，ADA治疗开始后4周时血清MMP-3水平的高改善率能够预测RA患者52周时的病情缓解情况。
