title: Serum matrix metalloproteinase 3 levels during treatment with sulfasalazine or combination of methotrexate and sulfasalazine in patients with early rheumatoid arthritis.
abstract: OBJECTIVE
  To determine the effects of treatment with sulfasalazine (SSZ) or the combination of methotrexate (MTX) and SSZ on serum matrix metalloproteinase 3 (MMP-3) levels in patients with early rheumatoid arthritis (RA).
  
  
  METHODS
  Eighty-two patients with early RA (symptoms < 1 year and DMARD-naive at presentation) were selected who had been treated with SSZ (2000 mg/day) or with the combination of MTX (7.5-15 mg/week) and SSZ. Serum MMP-3 levels, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), swollen joint count (SJC), tender joint count (TJC), Ritchie articular index (RAI), and the Disease Activity Score (DAS) were determined at 4 week intervals during a followup of 28 weeks for each treatment group. Response was based on clinical grounds and CRP at 12, 20, and 28 weeks.
  
  
  RESULTS
  SSZ responders (n = 52) had lower baseline values of serum MMP-3, CRP, and ESR, compared to partial/nonresponders (n = 30), but did not differ in joint scores and DAS. In the SSZ responder group all variables decreased. In the SSZ partial/nonresponders, CRP, ESR, and SJC decreased in contrast to serum MMP-3, TJC. RAI, and DAS-3. After addition of MTX all variables decreased in 24 of the 30 patients who had shown a partial or no response taking SSZ. In the SSZ responders there was a delayed decrease in serum MMP-3 compared to CRP.
  
  
  CONCLUSIONS
  Serum MMP-3 levels decrease in patients with early RA who respond to SSZ or to the combination of MTX and SSZ. In patients who respond to SSZ the changes in serum MMP-3 levels indicate a delayed response compared to CRP.
authors.affiliation: Department of Rheumatology, University Hospital Groningen, The Netherlands. m.posthumus@int.azg.nl
authors.forename: Marcel D
authors.initials: MD
authors.lastname: Posthumus
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Limburg
authors.forename: Johanna
authors.initials: J
authors.lastname: Westra
authors.forename: Miek A
authors.initials: MA
authors.lastname: van Leeuwen
authors.forename: Martin H
authors.initials: MH
authors.lastname: van Rijswijk
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000097:blood*; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D011446:Prospective Studies; D012460:Sulfasalazine / Q000008:administration & dosage*
chemical_list: D018501:Antirheumatic Agents; D012460:Sulfasalazine; D002097:C-Reactive Protein; D019278:Matrix Metalloproteinase 3; D008727:Methotrexate