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Improvement in matrix metalloproteinase-3 independently predicts low disease activity at 52 weeks in bio-switch rheumatoid arthritis patients treated with abatacept


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22

 

  1. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya; and Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
  2. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. nobunori@med.nagoya-u.ac.jp
  3. Department of Orthopaedic Surgery and Rheumatology, Nagoya Medical Center, Nagoya, Japan.
  4. Department of Orthopaedic Surgery and Rheumatology, Nagoya Medical Center, Nagoya, Japan.
  5. Department of Rheumatology, Toyohashi Municipal Hospital, Toyohashi, Japan.
  6. Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan.
  7. Department of Orthopaedic Surgery, Toyota Kosei Hospital, Toyota, Japan.
  8. Department of Orthopaedic Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan.
  9. Department of Rheumatology, Tokyo Shinjuku Medical Center, Shinjuku-ku, Tokyo, Japan.
  10. Department of Orthopaedic Surgery, Nagoya Central Hospital, Nagoya, Japan.
  11. Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
  12. Kato Orthopaedic Clinic, Okazaki, Japan.
  13. Department of Orthopaedic Surgery, Kariya-Toyota General Hospital, Kariya, Japan.
  14. Department of Orthopaedic Surgery, Shizuoka Kosei Hospital, Shizuoka, Japan.
  15. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  16. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  17. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  18. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  19. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  20. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  21. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  22. Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

CER12540
2020 Vol.38, N°5
PI 0933, PF 0939
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PMID: 32083543 [PubMed]

Received: 28/06/2019
Accepted : 18/10/2019
In Press: 04/02/2020
Published: 02/10/2020

Abstract

OBJECTIVES:
To explore predictive factors including MMP-3 for achievement of low disease activity (LDA) at 52 weeks in bio-switch rheumatoid arthritis (RA) patients treated with abatacept, for whom obtaining a good clinical response can be difficult.
METHODS:
Participants were 423 consecutive patients with RA treated with abatacept who were observed for longer than 52 weeks and registered in the TBCR, a Japanese multicentre registry system. Multivariate logistic regression analysis was used to study factors that predict the achievement of LDA at 52 weeks in bio-naïve (n=234) and bio-switch (n=189) groups.
RESULTS:
ROC analysis revealed that MMP-3 improvement rates at 12 weeks in bio-switch patients had the highest AUC with a cut-off value of 20.0% for predicting LDA achievement at 52 weeks. Multivariate logistic regression analysis revealed that, in addition to DAS28-CRP at baseline, achieving 20% improvement in MMP-3 levels at 12 weeks was an independent predictive factor (adjusted OR: 4.277, p=0.003) in the bio-switch group, whereas DAS28 was the only predictor in the bio-naïve group. Patients who achieved 20% improvement in MMP-3 levels at 12 weeks had significantly higher achievement rates of LDA at 52 weeks compared to those who did not achieve 20% improvement in the bio-switch group (60.0 vs. 33.3%, p=0.001).
CONCLUSIONS:
Our findings suggest that improvement in MMP-3 levels is key to predicting the clinical efficacy of abatacept. Closer attention paid not only to major clinical indices, but also changes in MMP-3 levels, could improve our ability to optimise clinical results when treating bio-switch patients.

Rheumatology Article