Serum levels of cartilage oligomeric matrix protein (COMP): a rapid decrease in patients with active rheumatoid arthritis undergoing intravenous steroid treatment.
To examine the influence of intravenous steroid-treatment (IST) on serum levels of Cartilage oligomeric matrix protein (COMP) in patients with active rheumatoid arthritis (RA). Serum levels of COMP and C-reactive protein (CRP) were measured in 12 patients with highly active RA (Steinbrocker stages II-IV) and in 5 patients with highly active reactive arthritis (ReA) (positive testing for HLA-B27) before starting daily IST. Patients received a total steroid dosage between 100 and 500 mg of prednisolone. COMP was measured by a commercially available sandwich-type ELISA-kit developed by AnaMar Medical AB, Sweden. Statistical evaluation was calculated by paired t test. In the RA group, COMP levels ranged from 6.3 to 19.4 U/l (mean 12.9 U/l), CRP from 5 to 195 mg/l (mean 77.8 mg/l), the COMP levels of the ReA group ranged from 5.1 to 7.4 U/l (mean 7.9 U/l), the CRP levels from 13 to 126 mg/l (mean 49 mg/l). We found a significant difference between the initial COMP levels in RA+ and ReA patients (P<0.005). In contrast to the ReA group, serum-COMP levels of RA+ patients (P<0.004) and the VAS (P<0.0001) decreased significantly within 2-10 days after the first treatment with steroids. The CRP levels remained unchanged in both groups. Our results indicate that the intravenous treatment with steroids in patients with highly active RA leads to a significant decrease of cartilage degradation. COMP seems to be a valuable parameter not even as a prognostic factor, but as a marker for monitoring the therapy response in patients with RA.
Institut für Rheumatologie der Kurstadt Baden in Kooperation mit der Donauuniversität Krems, Marchetstrasse 78, 2500, Baden, Austria. martin.skoumal@a1.net
M
M
Skoumal
G
G
Haberhauer
J
J
Feyertag
E M
EM
Kittl
K
K
Bauer
A
A
Dunky
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000378:metabolism; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D064236:Cartilage Oligomeric Matrix Protein; D004305:Dose-Response Relationship, Drug; D016326:Extracellular Matrix Proteins / Q000097:blood*; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007275:Injections, Intravenous; D064235:Matrilin Proteins; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D000091402:Prohibitins
D018501:Antirheumatic Agents; D064236:Cartilage Oligomeric Matrix Protein; D016326:Extracellular Matrix Proteins; D006023:Glycoproteins; D064235:Matrilin Proteins; C000717331:PHB2 protein, human; D000091402:Prohibitins; C577553:TSP5 protein, human; D002097:C-Reactive Protein; D011239:Prednisolone