RESEARCH - Connective tissue metabolism in patients with unclassified polyarthritis and early RA

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J Rheumatol. 2004 Sep;31(9):1698-708.

Connective tissue metabolism in patients with unclassified polyarthritis

and early rheumatoid arthritis. Relationship to disease activity, bone

mineral density, and radiographic outcome.

Jensen T, Klarlund M, Hansen M, Jensen KE, Skjodt H, Hyldstrup L.

Department of Rheumatology, H:S Hvidovre Hospital, University of

Copenhagen, Hvidovre, Denmark.

OBJECTIVE: To assess the applicability of serum concentrations of

markers of synovial inflammation, cartilage, and bone metabolism in

relation to conventional markers of disease activity, bone mineral

density (BMD) of the hand, and radiographic outcome. METHODS:

Biochemical markers of collagen tissue metabolism were measured in 72

patients with symmetrically swollen and tender second and third

metacarpophalangeal or proximal interphalangeal joints for at least 4

weeks and less than 2 years. At 2 years, 51 patients fulfilled the

American College Rheumatology criteria for rheumatoid arthritis (RA) and

21 patients had unclassified polyarthritis. Patients with RA were

divided into groups according to the mean disease activity and to

magnetic resonance imaging and radiographically detected bone erosions

in the hands. RESULTS: Patients with RA had significantly higher serum

concentrations of matrix metalloproteinase-3 (MMP-3) at baseline and

higher mean concentrations of serum MMP-3 and pyridinoline (Pyd) during

the first 6 and 12 months than patients with unclassified polyarthritis.

RA patients with persistent disease activity and erosive disease had

significantly higher concentrations of serum MMP-3 and Pyd than patients

with no disease activity or nonerosive disease. Significant mutual

correlations between serum MMP-3 and Pyd and C-reactive protein and

erythrocyte sedimentation rate were observed. The mean values of MMP-3

and Pyd correlated significantly to the alpha coefficient of the digital

x-ray radiogrammetry (DXR-BMD).

CONCLUSION: Serum MMP-3 and Pyd varied according to disease activity,

periarticular osteoporosis measured by DXR, and radiographic outcome,

and thus appear to supplement the conventional markers of disease

activity for monitoring patients with RA.

PMID: 15338487

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5338487 & dopt=Abstract

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