title: M-ficolin levels reflect disease activity and predict remission in early rheumatoid arthritis.
abstract: OBJECTIVE
  To assess plasma M-ficolin concentrations in disease-modifying antirheumatic drug (DMARD)-naive patients with early rheumatoid arthritis (RA), to investigate the correlation of M-ficolin concentrations with disease activity markers, and to determine the predictive value of M-ficolin with respect to the Disease Activity Score in 28 joints (DAS28).
  
  
  METHODS
  The study group included 180 DMARD-naive patients with early RA who participated in a randomized controlled trial of methotrexate and intraarticular glucocorticoids plus either adalimumab or placebo/adalimumab. One hundred healthy control subjects and 51 patients with chronic RA were also assessed. A sandwich-type time-resolved fluorometric immunoassay was used for quantification of plasma M-ficolin.
  
  
  RESULTS
  At baseline, M-ficolin levels were highest in the group of DMARD-naive patients with newly diagnosed active RA, and the level in these patients decreased 26% after 1 year of aggressive treatment. The baseline M-ficolin level correlated with 5 of 7 disease activity markers, including the DAS28 and the Health Assessment Questionnaire (HAQ), and a similar pattern of correlations was observed at 1 year. Multiple logistic regression analysis showed that an elevated M-ficolin level at baseline was the strongest predictor of not achieving either DAS28 remission (odds ratio [OR] 4.18, 95% confidence interval [95% CI] 2.02-8.63) or low disease activity (OR 2.45, 95% CI 1.13-5.28) at 1 year. The presence of a baseline M-ficolin level in the lowest quartile resulted in sensitivity of 29%, specificity of 93%, and positive predictive value of 95% for low disease activity at 1 year.
  
  
  CONCLUSIONS
  In patients with early RA, elevated plasma M-ficolin levels correlated with a high DAS28 and a high HAQ score at baseline and 1 year. A low M-ficolin level was the strongest predictor of remission and low disease activity in a multivariate analysis.
authors.affiliation: Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Ammitzbøll
authors.forename: Steffen
authors.initials: S
authors.lastname: Thiel
authors.forename: Jens C
authors.initials: JC
authors.lastname: Jensenius
authors.forename: Torkell
authors.initials: T
authors.lastname: Ellingsen
authors.forename: Kim
authors.initials: K
authors.lastname: Hørslev-Petersen
authors.forename: Merete L
authors.initials: ML
authors.lastname: Hetland
authors.forename: Peter
authors.initials: P
authors.lastname: Junker
authors.forename: Niels S
authors.initials: NS
authors.lastname: Krogh
authors.forename: Mikkel
authors.initials: M
authors.lastname: Østergaard
authors.forename: Kristian
authors.initials: K
authors.lastname: Stengaard-Pedersen
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D037102:Lectins / Q000097:blood*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011237:Predictive Value of Tests; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome; D000097604:Ficolins
chemical_list: D000068879:Adalimumab; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D037102:Lectins; D008727:Methotrexate; D000097604:Ficolins