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Early increase in serum-COMP is associated with joint damage progression over the first five years in patients with rheumatoid arthritis

Andersson, Maria L. E.; Svensson, Bjorn; Petersson, Ingemar LU ; Hafstrom, Ingiald; Albertsson, Kristina; Forslind, Kristina LU ; Heinegård, Dick LU and Saxne, Tore LU (2013) In BMC Musculoskeletal Disorders 14.
Abstract
Background: Currently available biomarkers for the early tissue process leading to joint damage in rheumatoid arthritis are insufficient and lack prognostic accuracy, possibly a result of variable activity of the disease over time. This study represents a novel approach to detect an altered activity of the disease process detected as increasing serum-COMP levels over a short time and whether this would correlate with joint damage progression over the first 5 years of disease. Methods: In all, 349 patients from the Swedish BARFOT early RA study were examined. Serum-COMP was analysed by ELISA at diagnosis and after 3 months. Based on changes in serum-COMP levels, three subgroups of patients were defined: those with unchanged levels (change... (More)
Background: Currently available biomarkers for the early tissue process leading to joint damage in rheumatoid arthritis are insufficient and lack prognostic accuracy, possibly a result of variable activity of the disease over time. This study represents a novel approach to detect an altered activity of the disease process detected as increasing serum-COMP levels over a short time and whether this would correlate with joint damage progression over the first 5 years of disease. Methods: In all, 349 patients from the Swedish BARFOT early RA study were examined. Serum-COMP was analysed by ELISA at diagnosis and after 3 months. Based on changes in serum-COMP levels, three subgroups of patients were defined: those with unchanged levels (change <= 20%) (N=142), decreasing levels (> 20%) (N=173) and increasing levels (> 20%) (N=34). Radiographs of hands and feet were obtained at inclusion, after 1, 2 and 5 years and scored according to Sharp van der Heijde (SHS). Radiographic progression was defined as increase in SHS by >= 5.8. Results: The group of patients with increasing COMP levels showed higher median change in total SHS and erosion scores at 1, 2 and 5 year follow-up compared with the groups with stable or decreasing COMP levels. Furthermore, the odds ratio of radiographic progression was 2.8 (95% CI 1.26-6.38) for patients with increasing COMP levels vs. patients with unchanged levels. The group of patients with increasing COMP levels had higher ESR at inclusion but there were no baseline differences between the groups for age, gender, disease duration, disease activity (DAS28), function (HAQ), CRP, nor presence of rheumatoid factor or anti-CCP. Importantly, neither did changes over the 3-month period in DAS28, HAQ, ESR nor CRP differ between the groups and these variables did not correlate to joint damage progression. Conclusion: Increasing serum-COMP levels between diagnosis and the subsequent 3 months in patients with early RA represents a novel indicator of an activated destructive process in the joint and is a promising tool to identify patients with significant joint damage progression during a 5-year period. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cartilage oligomeric matrix protein, COMP, Rheumatoid arthritis, Biomarkers, Radiographic joint damage progression
in
BMC Musculoskeletal Disorders
volume
14
publisher
BioMed Central
external identifiers
  • wos:000322896500001
  • scopus:84880950076
ISSN
1471-2474
DOI
10.1186/1471-2474-14-229
language
English
LU publication?
yes
id
5557fd35-7984-483a-8bec-6d8e338f274c (old id 4042707)
date added to LUP
2013-10-01 15:17:20
date last changed
2019-02-20 06:44:14
@article{5557fd35-7984-483a-8bec-6d8e338f274c,
  abstract     = {Background: Currently available biomarkers for the early tissue process leading to joint damage in rheumatoid arthritis are insufficient and lack prognostic accuracy, possibly a result of variable activity of the disease over time. This study represents a novel approach to detect an altered activity of the disease process detected as increasing serum-COMP levels over a short time and whether this would correlate with joint damage progression over the first 5 years of disease. Methods: In all, 349 patients from the Swedish BARFOT early RA study were examined. Serum-COMP was analysed by ELISA at diagnosis and after 3 months. Based on changes in serum-COMP levels, three subgroups of patients were defined: those with unchanged levels (change &lt;= 20%) (N=142), decreasing levels (&gt; 20%) (N=173) and increasing levels (&gt; 20%) (N=34). Radiographs of hands and feet were obtained at inclusion, after 1, 2 and 5 years and scored according to Sharp van der Heijde (SHS). Radiographic progression was defined as increase in SHS by &gt;= 5.8. Results: The group of patients with increasing COMP levels showed higher median change in total SHS and erosion scores at 1, 2 and 5 year follow-up compared with the groups with stable or decreasing COMP levels. Furthermore, the odds ratio of radiographic progression was 2.8 (95% CI 1.26-6.38) for patients with increasing COMP levels vs. patients with unchanged levels. The group of patients with increasing COMP levels had higher ESR at inclusion but there were no baseline differences between the groups for age, gender, disease duration, disease activity (DAS28), function (HAQ), CRP, nor presence of rheumatoid factor or anti-CCP. Importantly, neither did changes over the 3-month period in DAS28, HAQ, ESR nor CRP differ between the groups and these variables did not correlate to joint damage progression. Conclusion: Increasing serum-COMP levels between diagnosis and the subsequent 3 months in patients with early RA represents a novel indicator of an activated destructive process in the joint and is a promising tool to identify patients with significant joint damage progression during a 5-year period.},
  articleno    = {229},
  author       = {Andersson, Maria L. E. and Svensson, Bjorn and Petersson, Ingemar and Hafstrom, Ingiald and Albertsson, Kristina and Forslind, Kristina and Heinegård, Dick and Saxne, Tore},
  issn         = {1471-2474},
  keyword      = {Cartilage oligomeric matrix protein,COMP,Rheumatoid arthritis,Biomarkers,Radiographic joint damage progression},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Musculoskeletal Disorders},
  title        = {Early increase in serum-COMP is associated with joint damage progression over the first five years in patients with rheumatoid arthritis},
  url          = {http://dx.doi.org/10.1186/1471-2474-14-229},
  volume       = {14},
  year         = {2013},
}