Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden.
Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands.
Rheumatology (Oxford). 2023 Mar 1;62(3):1350-1355. doi: 10.1093/rheumatology/keac442.
To investigate whether biomarkers are modulated by prednisolone treatment in patients with hand OA and whether they can predict response to prednisolone.
Biomarkers reflecting tissue turnover and inflammation [aggrecanase-derived neoepitope of arggecan (ARGS), MMP-derived neoepitope of type I collagen (C1M), MMP-derived neoepitope of type III collagen (C3M), marker of true type V collagen formation (PROC5), MMP-derived neoepitope of CRP (CRPM), citrullinated vimentin fragment (VICM), high-sensitivity (hsCRP)] were measured in sera from 78 patients with painful inflammatory hand OA, who were randomized between prednisolone or placebo treatment. Association of baseline biomarker levels with disease characteristics [visual analogue scale (VAS) pain, synovial thickening ultrasonography sum score and erosive OA] and OMERACT-Osteoarthritis Research Society International (OARSI) response after 6 weeks were analysed with linear or logistic regression and adjusted for age, BMI and sex. Change in biomarker levels after 6 weeks was assessed with linear regression adjusted for baseline biomarker levels, age, BMI and sex.
For all patients (mean age 64 years, 79% female), there were no associations between biomarker levels and VAS finger pain or synovial thickening score at baseline. Patients with erosive hand OA had higher levels of C1M and hsCRP [adjusted geometric mean ratio 1.24 (95% CI 1.03, 1.49) and 1.91 (1.19, 3.06), respectively]. Biomarker levels did not decrease over time. There was no association between baseline biomarkers levels and OARSI response, except for CRPM [geometric mean ratio of 0.88 (0.77, 1.00)].
Erosive disease was associated with higher levels of C1M and hsCRP. Biomarker levels were not influenced by treatment with prednisolone. Current biomarkers were not associated with response to prednisolone in hand OA.
研究生物标志物是否在手 OA 患者中受泼尼松龙治疗调节,以及它们是否可以预测对泼尼松龙的反应。
在 78 例患有疼痛性炎症性手部 OA 的患者中测量了反映组织转化和炎症的生物标志物[聚集蛋白聚糖衍生的新型抗原(ARGS),I 型胶原衍生的 MMP 新型抗原(C1M),III 型胶原衍生的 MMP 新型抗原(C3M),真正的 V 型胶原形成标志物(PROC5),C 反应蛋白衍生的 MMP 新型抗原(CRPM),瓜氨酸化波形蛋白片段(VICM),高敏(hsCRP)],这些患者被随机分为泼尼松龙或安慰剂治疗组。使用线性或逻辑回归分析与基线生物标志物水平与疾病特征[视觉模拟量表(VAS)疼痛,滑膜增厚超声(sum score)和侵蚀性 OA]和 6 周后 OMERACT-骨关节炎研究协会国际(OARSI)反应的关系,并根据年龄,BMI 和性别进行调整。使用线性回归,根据基线生物标志物水平,年龄,BMI 和性别调整 6 周后生物标志物水平的变化。
对于所有患者(平均年龄 64 岁,79%为女性),基线时生物标志物水平与 VAS 手指疼痛或滑膜增厚评分之间均无关联。患有侵蚀性手部 OA 的患者 C1M 和 hsCRP 水平较高[调整后的几何均数比分别为 1.24(95%CI 1.03,1.49)和 1.91(1.19,3.06)]。生物标志物水平没有随时间下降。除 CRPM 外,基线生物标志物水平与 OARSI 反应之间没有关联[几何均数比为 0.88(0.77,1.00)]。
侵蚀性疾病与 C1M 和 hsCRP 水平较高有关。泼尼松龙治疗未影响生物标志物水平。当前的生物标志物与手部 OA 对泼尼松龙的反应无关。