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SAT0177 The Combination of Serum Matrix Metalloproteinase-3 and C-Reactive Protein at 4 Weeks Predict High Continuation Rate in RA Patients with Adalimumab Therapy
  1. Y. Hattori1,
  2. A. Kaneko1,
  3. D. Kida1,
  4. N. Takahashi2,
  5. H. Kanda1,
  6. T. Kojima2,
  7. N. Ishiguro2
  8. on behalf of TBCR Study Group
  1. 1Orthopaedic Surgery and Rheumatology, National Hospital Organization Nagoya Medical Center
  2. 2Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

Abstract

Background Serum matrix metalloproteinase-3 (MMP-3) is a specific inflammatory marker of the synovium in patients with rheumatoid arthritis (RA).

Objectives Our aim in this study is to investigate whether serum MMP-3 is the predictor for continuation rate in treatment for RA patients with biologics.

Methods We analyzed 220 patients with adalimumab (ADA) therapy in the multicenter study group (Tsurumai Biologics Communication Registry; TBCR). We divided into 2 groups based on the improvement of serum level of MMP-3 and CRP: high rate of improvement (MMP-HR group) and low rate of improvement (MMP-LR group) in serum MMP-3 levels at 4 weeks (Fig.1a), and: high rate of improvement (CRP-HR group) and low rate of improvement (CRP-LR group) in serum CRP levels at 4 weeks (Fig.1c). We also divided into 2 groups based on the serum level of MMP-3 and CRP: high value (MMP-H group) and low value (MMP-L group) in serum MMP-3 levels at 4 weeks (Fig.2a), and: high value (CRP-H group) and low value (CRP-L group) in serum CRP levels at 4 weeks (Fig.2c). We evaluated the continuation rate at 3 years in 2 groups, respectively. Kaplan-Meier curves were generated to estimate the continuation rate. The sensitivity and specificity for the best cut-off lebel was analyzed by a receiver-operated characteristic (ROC) curve.

Results The continuation rate of ADA therapy was 54% at 3 years. The rate of continuation in MMP-HR group (63%) is significantly higher than in MMP-LR group (45%) (Fig.1b). The rate of continuation in CRP-HR group (61%) is significantly higher than in CRP-LR group (47%) (Fig.1d). The rate of continuation in MMP-H group (46%) is significantly lower than in MMP-L group (62%) (Fig.2b). The rate of continuation in CRP-H group (41%) is significantly lower than in CRP-L group (71%) (Fig.2d). Moreover, the rate of continuation in (MMP and CRP)-HR group (65%) (Fig.3a) and (MMP and CRP)-L group (71%) (Fig.3b) is high. The best cut-off rate determined by ROC analysis of improvement of serum MMP-3 and CRP level at 4 weeks for determining continuation at 3 years was 5.5% (sensitivity: 69%, specificity: 51%) and 59.0% (sensitivity: 63%, specificity: 57%), respectively. The best cut-off value determined by ROC analysis of serum MMP-3 and CRP level at 4 weeks for determining continuation at 3 years was 118.8 (ng/mL) (sensitivity: 62%, specificity: 55%) and 0.23 (mg/dL) (sensitivity: 66%, specificity: 62%), respectively.

MMP-HR group: high rate of improvement in serum MMP-3 levels at 4 weeks. MMP-LR group: low rate of improvement in serum MMP-3 levels at 4 weeks. CRP-HR group: high rate of improvement in serum CRP levels at 4 weeks. CRP-LR group: low rate of improvement in serum CRP levels at 4 weeks. MMP-H-group: high value in serum MMP-3 levels at 4 weeks. MMP-L group: low value in serum MMP-3 levels at 4 weeks. CRP-H group: high value in serum CRP levels at 4 weeks. CRP-L group: low value in serum CRP levels at 4 weeks.

Conclusions High rate of improvement and low value in serum MMP-3 at 4 weeks yield better continuation for the treatment of RA patients. We considered that the combination of serum MMP-3 and CRP at 4 weeks can be useful for predicting the rate of continuation in RA patients with ADA therapy.

Disclosure of Interest Y. Hattori Grant/research support from: Chugai Pharma Corporation, Pfizer, Abbvie, UCB, Bristol-Myers Squibb, Janssen Pharma, and Nichi-Iko Pharmaceutical Corporation., A. Kaneko Grant/research support from: Chugai Pharma Corporation, Pfizer, Abbvie, UCB, Bristol-Myers Squibb, Janssen Pharma, and Nichi-Iko Pharmaceutical Corporation., D. Kida Grant/research support from: Chugai Pharma Corporation, Pfizer, Abbvie, UCB, Bristol-Myers Squibb, Janssen Pharma, and Nichi-Iko Pharmaceutical Corporation., N. Takahashi Speakers bureau: Abbvie, Eisai Corporation, Mitsubishi Tanabe Pharma Corporation, Takeda Pharma Corporation, Pfizer, Chugai Pharma Corporation, and Bristol-Myers Squibb., H. Kanda Grant/research support from: Chugai Pharma Corporation, Pfizer, Abbvie, UCB, Bristol-Myers Squibb, Janssen Pharma, and Nichi-Iko Pharmaceutical Corporation., T. Kojima Speakers bureau: Takeda Pharma Corporation, Janssen Pharmaceutical, Astellas Pharma Corporation, Mitsubishi Tanabe Pharma Corporation, Takeda Pharma Corporation, Eisai Pharma Corporation, Abbvie, Bristol-Myers Squibb, Pfizer, and Chugai Pharma Corporation., N. Ishiguro Speakers bureau: AbbVie, Chugai Pharma Corporation, Mitsubishi Tanabe Pharma Corporation, Daiichi-Sankyo, Eisai Pharma Corporation, Pfizer, and Takeda Pharma Corporation.

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