title: Clinically relevant radiographic progression in joint destruction in RA patients with abnormal MMP-3 or high levels of CRP despite 1-year treatment with infliximab.
abstract: OBJECTIVE
  Identify the independently related factors of joint destruction progression in RA patients despite of infliximab treatment.
  
  
  METHODS
  The subjects were cases who underwent infliximab treatment for one year or longer in our department (n = 244). Patients in which modified total sharp score (mTSS), joint erosion (JE), and joint space narrowing (JSN) had advanced to the standard value (3.0) or more for one year were defined as mTSS- Clinically-Relevant-Rapid Progression (CRRP) (n = 20), JE-CRRP (n = 20), and JSN-CRRP (n = 23), and the respective related factors at baseline and week 54 were defined by multiple logistic regression.
  
  
  RESULTS
  The median disease duration was 24 months and median mTSS 9.0 at baseline. The median DAS28, CRP, and yearly progression of mTSS improved from 5.8 to 2.6, 1.2 to 0.1 mg/dL, and 4.4 to 0.0 point/year, respectively. The related factor in each of mTSS-CRRP, JE-CRRP, and JSN-CRRP was high CRP levels at baseline. At week 54, the related factor of mTSS-CRRP and JSN-CRRP was high MMP-3 titer; however, the related factor of JE-CRRP was high CRP levels.
  
  
  CONCLUSIONS
  High CRP levels at baseline were an independent predictive factor of joint destruction advancement during infliximab treatment. Moreover, it was believed that abnormal MMP-3 at week 54 was the index for mTSS and JSN advancement, while high CRP levels were the index for JE advancement.
authors.affiliation: a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Nawata
authors.affiliation: a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Saito
authors.affiliation: a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Fukuyo
authors.affiliation: a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hirata
authors.affiliation: a The First Department of Internal Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002097:C-Reactive Protein / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000097:blood*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D002097:C-Reactive Protein; D000069285:Infliximab; C511768:MMP3 protein, human; D019278:Matrix Metalloproteinase 3
keywords: Infliximab; Matrix metalloproteinase-3; Radiographic progression; Rheumatoid arthritis; Tumor necrosis factor antagonist