Relations of serum COMP to cardiovascular risk factors and endothelial function in patients with rheumatoid arthritis treated with methotrexate and TNF-α inhibitors.
OBJECTIVE
To examine whether serum level of cartilage oligomeric matrix protein (S-COMP) is related to methotrexate (MTX) or to MTX and tumor necrosis factor-α (TNF-α) combination treatment for rheumatoid arthritis (RA); and to investigate whether S-COMP is related to cardiovascular risk factors including endothelial dysfunction and level of anticitrullinated protein antibodies (ACPA) in patients with RA.


METHODS
Clinical and laboratory measures, including S-COMP and reactive hyperemic index (RHI), were examined in 55 consecutive patients with RA starting with either MTX (n = 34) or MTX and anti-TNF-α treatment (n = 21) at baseline, and after 6 weeks and 6 months.


RESULTS
S-COMP was similar in the 2 treatment regimens during followup. We found a positive relationship between S-COMP at baseline and the use of disease-modifying antirheumatic drugs the last year preceding the study (p = 0.001), and a negative relation to current use of systemic glucocorticosteroids (p = 0.044). The nonsignificant change in S-COMP between baseline and the 6-month followup was positively and independently related to change in ACPA level (p = 0.009). There was no significant association between RHI and level of S-COMP at baseline.


CONCLUSIONS
The cartilage turnover marker S-COMP did not change significantly after 6 months' treatment with MTX with or without a TNF-α inhibitor in patients with RA. The positive association between S-COMP and ACPA suggests that these factors might interact, and could both be contributors to an unknown link between inflammation and cartilage destruction in patients with RA. S-COMP was not related to endothelial function in patients with RA, or to other cardiovascular risk factors studied. Clinical Trials registration number NCT00902005.
Lillehammer Hospital for Rheumatic Diseases, M. Grundtvigsv. 6, 2609 Lillehammer, Norway. Gunn.Hjeltnes@Revmatismesykehuset.no
Gunnbjørg
G
Hjeltnes
Ivana
I
Hollan
Øystein
Ø
Førre
Allan
A
Wiik
Torstein
T
Lyberg
Knut
K
Mikkelsen
Stefan
S
Agewall
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology*; D064236:Cartilage Oligomeric Matrix Protein; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects*; D016326:Extracellular Matrix Proteins / Q000097:blood*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D006940:Hyperemia / Q000097:blood / Q000188:drug therapy; D008297:Male; D064235:Matrilin Proteins; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D018501:Antirheumatic Agents; D064236:Cartilage Oligomeric Matrix Protein; D016326:Extracellular Matrix Proteins; D005938:Glucocorticoids; D006023:Glycoproteins; D064235:Matrilin Proteins; C577553:TSP5 protein, human; D014409:Tumor Necrosis Factor-alpha; D008727:Methotrexate