基质金属蛋白酶7和纤维蛋白原α链基线与早期类风湿关节炎患者3个月时甲氨蝶呤应答的关系

IF 2.1 Q3 RHEUMATOLOGY
Karen Hambardzumyan, Carl Hamsten, Lucía Lourido, Saedis Saevarsdottir, Peter Nilsson, Ronald F van Vollenhoven, Per-Johan Jakobsson, Helena Idborg
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引用次数: 0

摘要

背景:甲氨蝶呤(MTX)应答者的识别将优化早期类风湿关节炎(eRA)患者的治疗。我们的目的是鉴定用于预测MTX反应的蛋白质生物标志物。方法:我们分析了来自瑞典药物治疗(SWEFOT)试验人群(试验注册号:NCT00764725)的eRA患者(N = 135)。177种具有炎症特征的蛋白的基线血清水平通过悬浮头阵列格式的380种抗体进行了分析。分析蛋白水平与MTX治疗3个月后达到低28关节疾病活动评分(LDA = DAS28≤3.2)(主要结局)或根据欧洲风湿病协会联盟(EULAR)标准获得良好反应(次要结局)的关系。结果:多变量分析显示,基线时177种蛋白中的两种血清水平,基质金属蛋白酶7 (MMP-7)和纤维蛋白原α链(FGA)在3个月时达到LDA和未达到LDA的患者之间存在显著差异。在MMP-7或FGA水平低与高的患者中,分别有60%对24%和58%对22%达到了LDA (p)。结论:基线时低水平的MMP-7和FGA与eRA患者临床结果的改善相关。现在有必要在另一个eRA队列中验证这些结果,如果得到证实,它可能有助于临床决策,决定是在单药治疗中开始使用MTX还是更有效的替代方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of matrix metalloproteinase 7 and the alpha-chain of fibrinogen at baseline with response to methotrexate at 3 months in patients with early rheumatoid arthritis.

Background: The identification of responders to methotrexate (MTX) would optimize the therapy of patients with early rheumatoid arthritis (eRA). Our aim was to identify protein biomarkers for the prediction of the response to MTX.

Methods: We analysed patients with eRA (N = 135) from the Swedish Pharmacotherapy (SWEFOT) trial population (Trial registration number: NCT00764725). Baseline serum levels of 177 proteins with an inflammatory signature were profiled via 380 antibodies in a suspension bead array format. Protein levels were analysed for their associations with the achievement of a low 28-joint disease activity score (LDA = DAS28 ≤ 3.2) after 3 months of MTX therapy (primary outcome) or a good response according to the European Alliance of Associations for Rheumatology (EULAR) criteria (secondary outcome).

Results: Multivariable analysis revealed that the serum levels of two of the 177 proteins at baseline, matrix metalloproteinase 7 (MMP-7) and the alpha-chain of fibrinogen (FGA), were significantly different between patients who did and did not achieve LDA at 3 months. Among patients with low versus high levels of either MMP-7 or FGA, 60% versus 24% and 58% versus 22%, respectively, achieved LDA (p < 0.001). Among patients with low levels of both proteins, 79% achieved LDA at 3 months, whereas only 18% of those with high levels of both proteins achieved LDA at 3 months (p < 0.001). The results were similar when a secondary outcome was used.

Conclusions: Low levels of MMP-7 and FGA at baseline were associated with improved clinical outcomes in eRA patients. Validation of these results in another eRA cohort is now warranted, and if confirmed, it may facilitate clinical decision-making regarding whether to start with MTX in monotherapy or more potent alternatives.

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来源期刊
BMC Rheumatology
BMC Rheumatology Medicine-Rheumatology
CiteScore
3.80
自引率
0.00%
发文量
73
审稿时长
15 weeks
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