title: A combination of biochemical markers of cartilage and bone turnover, radiographic damage and body mass index to predict the progression of joint destruction in patients with rheumatoid arthritis treated with disease-modifying anti-rheumatic drugs.
abstract: The aim of this study was to evaluate the predictive value of biological, radiological and clinical parameters for the progression of radiographic joint damage in rheumatoid arthritis (RA) patients treated with conventional disease-modifying anti-rheumatic drugs (DMARDs). We analyzed the 145 patients with active RA for less than 5 years who were participating in the prospective 1-year randomized controlled trial of tocilizumab (SAMURAI trial) as a control arm treated with conventional DMARDs. Progression of joint damage was assessed by sequential radiographs read by two independent blinded X-ray readers and scored for bone erosion and joint space narrowing (JSN) using the van der Heijde-modified Sharp method. Multivariate analysis revealed that increased urinary levels of C-terminal crosslinked telopeptide of type II collagen (U-CTX-II), an increased urinary total pyridinoline/total deoxypyridinoline (U-PYD/DPD) ratio and low body mass index (BMI) at baseline were independently associated with a higher risk for progression of bone erosion. In addition to these three variables, the JSN score at baseline was also significantly associated with an increased risk of progression of the JSN score and total Sharp score. High baseline U-CTX-II levels, U-PYD/DPD ratio and JSN score and a low BMI are independent predictive markers for the radiographically evident joint damage in patients with RA treated with conventional DMARDs.
authors.affiliation: Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Patrick
authors.initials: P
authors.lastname: Garnero
authors.forename: Désirée
authors.initials: D
authors.lastname: van der Heijde
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Miyasaka
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kawai
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Norihiro
authors.initials: N
authors.lastname: Nishimoto
mesh_terms: D000368:Aged; D000596:Amino Acids / Q000652:urine*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000652:urine*; D001175:Arthrography; D015415:Biomarkers / Q000652:urine; D024043:Collagen Type II / Q000652:urine*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D000596:Amino Acids; D018501:Antirheumatic Agents; D015415:Biomarkers; D024043:Collagen Type II; C015484:pyridinoline; C036020:deoxypyridinoline