Objectives To investigate the association of high baseline MMP-3 serum levels with hands and feet joints structural damage progression, estimated by ultrasonography (US), in patients with early, treatment “naïve” RA without X-ray visible erosions.
Methods Sixty-three pts. (9 males and 54 females; mean age 53.4 yrs 21–81±14.1) with early RA (EULAR/ACR 2010 criteria) and symptom duration of ≤12 months (mean duration of 3.8 months) had baseline serum MMP-3 levels tested. Patients had been DMARDs/glucocorticoid naïve, without visible X-ray erosions at the study entry. The subsequent structural joints damages, that were estimated by high frequency linear probe by ESAOTE My Lab 70 machine, as well as clinical markers of disease activity, in the first 2 years were followed. The presence of bone erosion was analyzed at the wrist, MCP2 and MCP5 joints of both hands, as well as at MTP5 joints according to OMERACT US group definition. In order to estimate progression of preexisting erosion the total volume (TV) of bone erosion were calculated by multiplying three diameters (mm): a-the length of erosion; diameter b- the width and diameter c-the depth of erosion. Anova statistical method was performed in data processing.
Results 46 pts. had basal serum MMP-3 level higher than normal (MMP-3 positive). The 504 joints were assessed summary by US on each visit. The 122 bone erosions in total (1.9 per patient) were depicted at baseline and 213 bone erosions (4.3 per patient) at follow-up visit in whole group. After 24 months MMP3 positive pts. had significantly higher total number of US erosions than MMP-3 negative (3.8 vs. 2.4, p=0.039). The total volume of bone erosion (mm3) was higher in MMP-3 positive than MMP-3 negative pts. after 24 months of treatment, but without statistical significance (18.6 vs. 8.9, p=0.07). MMP-3 positive pts. had a significantly higher value of ESR, CRP and DAS28 than MMP-3 negative pts. at the baseline visit (53.6 vs.25.9, p=0.002; 36.6 vs. 9.5, p=0.005; 6.0 vs. 4.8, p=0.002, respectively). All of those parameters were significantly decreased after 24 months in a group of MMP-3 positive compared to MMP-3 negative pts. (p=0.009, p=0.021, p=0.028, respectively).
Conclusions After 2-year of follow-up, US assessment showed a significantly higher number of new bone erosions in patients with early, treatment “naïve” RA and baseline MMP3 levels higher than normal (MMP3 positive) compared to patients with normal baseline levels of MMP3, as well as a biger TV of bone erosions but not statistically significant. The parameters of RA activity (ESR, CRP, DAS28) significantly correlated with baseline MMP-3 levels of higher than normal.
Disclosure of Interest None declared