 |
|
|
 |
Serum Matrix Metalloproteinase 3 Levels During Treatment with Sulfasalazine or Combination of Methotrexate and Sulfasalazine in Patients with Early Rheumatoid Arthritis
MARCEL D. POSTHUMUS, PIETER C. LIMBURG, JOHANNA WESTRA, MIEK A. van LEEUWEN, and MARTIN H. van RIJSWIJK
ABSTRACT.
Methods. Eighty-two patients with early RA (symptoms < 1 year and DMARD-naive at presentation) were selected who had been treated with SSZ (2000 mg/day) or with the combination of MTX (7.5-15 mg/week) and SSZ. Serum MMP-3 levels, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), swollen joint count (SJC), tender joint count (TJC), Ritchie articular index (RAI), and the Disease Activity Score (DAS) were determined at 4 week intervals during a followup of 28 weeks for each treatment group. Response was based on clinical grounds and CRP at 12, 20, and 28 weeks. Results. SSZ responders (n = 52) had lower baseline values of serum MMP-3, CRP, and ESR, compared to partial/nonresponders (n = 30), but did not differ in joint scores and DAS. In the SSZ responder group all variables decreased. In the SSZ partial/nonresponders, CRP, ESR, and SJC decreased in contrast to serum MMP-3, TJC, RAI, and DAS-3. After addition of MTX all variables decreased in 24 of the 30 patients who had shown a partial or no response taking SSZ. In the SSZ responders there was a delayed decrease in serum MMP-3 compared to CRP. Conclusion. Serum MMP-3 levels decrease in patients with early RA who respond to SSZ or to the combination of MTX and SSZ. In patients who respond to SSZ the changes in serum MMP-3 levels indicate a delayed response compared to CRP. (J Rheumatol 2002;29:883-9) Key Indexing Terms:
SERUM MATRIX METALLOPROTEINASE 3
From the Department of Rheumatology, University Hospital Groningen, Groningen, The Netherlands. Supported by a grant from Het Nationaal Reumafonds, The Netherlands. M.D. Posthumus, MD; P.C. Limburg, PhD; J. Westra, BSc; M.A. van Leeuwen, MD, PhD; M.H. van Rijswijk, MD, PhD, Department of Rheumatology. Address reprint requests to Dr. M.D. Posthumus, Department of Rheumatology, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. E-mail: m.posthumus@int.azg.nl Submitted April 26, 2001; revision accepted November 26, 2001. |