title: Osteoprotegerin and tumor necrosis factor-related apoptosis-inducing ligand as prognostic factors in rheumatoid arthritis: results from the ESPOIR cohort.
abstract: BACKGROUND
  We previously reported that low ratio of osteoprotegerin (OPG) to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was associated with Disease Activity Score in 28 joints (DAS28) remission at 6 months in patients with early rheumatoid arthritis (RA). Here, we aimed to evaluate the value of baseline OPG/TRAIL ratio in predicting clinical and radiological outcomes in patients with early RA in the ESPOIR cohort.
  
  
  METHODS
  OPG and TRAIL serum concentrations were assessed in the ESPOIR cohort patients. Patients with definite RA were included in this study. Patients were excluded if they had high erosion score at baseline (>90(th) percentile) or received biological therapy during the first 2 years of follow-up. Data were analyzed by univariate analysis and multivariate logistic regression to predict 1-year DAS28 remission and 2-year radiographic disease progression.
  
  
  RESULTS
  On univariate analysis of 399 patients, OPG/TRAIL ratio at baseline was significantly lower in patients with than without remission at 1 year (p = 0.015). On multivariate logistic regression including age, gender, body mass index and DAS28, low OPG/TRAIL ratio was independently associated with remission at 1 year (odds ratio 1.68 [95 % confidence interval 1.01-2.79]). On univariate analysis, high OPG/TRAIL ratio at baseline was associated with rapid progression of erosion at 2 years (p = 0.041), and on multivariate logistic regression including age, anti-citrullinated protein antibody positivity and C-reactive protein level, OPG/TRAIL ratio independently predicted rapid progression of erosion at 2 years.
  
  
  CONCLUSIONS
  OPG/TRAIL ratio at baseline was an independent predictor of 1-year remission and 2-year rapid progression of erosion for patients with early rheumatoid arthritis. Thus, OPG/TRAIL ratio could be included in matrix prediction scores to predict rapid radiographic progression. Further confirmation in an independent cohort is warranted.
authors.affiliation: Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. rachel.audo@igmm.cnrs.fr.|Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. rachel.audo@igmm.cnrs.fr.|Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France. rachel.audo@igmm.cnrs.fr.
authors.forename: Rachel
authors.initials: R
authors.lastname: Audo
authors.affiliation: Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. c-daien@chu-montpellier.fr.|Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. c-daien@chu-montpellier.fr.|Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France. c-daien@chu-montpellier.fr.
authors.forename: Claire
authors.initials: C
authors.lastname: Daien
authors.affiliation: Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. laura.papon@igmm.cnrs.fr.|Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France. laura.papon@igmm.cnrs.fr.
authors.forename: Laura
authors.initials: L
authors.lastname: Papon
authors.affiliation: Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. c-lukas@chu-montpellier.fr.|Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. c-lukas@chu-montpellier.fr.
authors.forename: Cédric
authors.initials: C
authors.lastname: Lukas
authors.affiliation: Department of Rheumatology and CIC/CRB 1404, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, 1, rue de Germont, 76031 Rouen, France. olivier.vittecoq@univ-rouen.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
authors.affiliation: Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. Michael.hahne@igmm.cnrs.fr.|Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France. Michael.hahne@igmm.cnrs.fr.|Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. Michael.hahne@igmm.cnrs.fr.
authors.forename: Michael
authors.initials: M
authors.lastname: Hahne
authors.affiliation: Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. b-combe@chu-montpellier.fr.|Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. b-combe@chu-montpellier.fr.|Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France. b-combe@chu-montpellier.fr.
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
authors.affiliation: Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. j-morel@chu-montpellier.fr.|Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. j-morel@chu-montpellier.fr.|Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France. j-morel@chu-montpellier.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Morel
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; D053221:TNF-Related Apoptosis-Inducing Ligand; C506030:TNFRSF11B protein, human; C505653:TNFSF10 protein, human