Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Early Increase In Serum-COMP Is Associated with Joint Damage Progression Over the First Five Years In Patients with Rheumatoid Arthritis.
Saxne7, Tore, Heinegard6, Dick, Forslind5, Kristina, Albertsson4, Kristina, Hafstrom4, Ingiald, Petersson3, Ingemar F., Svensson2, Bjorn
R&D centre, Spenshult Hospital for Rheumatic Diseases, Oskarstrom, Sweden, Oskartrom, Sweden
Paulinsvag 7D, Bastad, Sweden
Lund University Hosp, Lund, Sweden
Karoliska Institute, Stockholm, Sweden
University of Lund, Lund, Sweden
Dept of Clinical Sciences Lund, Section of Rheumatology, Lund, Sweden
Serum-COMP has shown promise as a prognostic indicator in rheumatoid arthritis (RA). However, serum concentrations may to some extent be genetically determined and thus reflect levels of cartilage matrix turnover not related to disease (Williams et al, 2006). We have examined if changes in serum-COMP early in the disease course of RA correlate with joint damage progression in hands and feet after 5 years.
In all 348 patients (64% women) included in the BARFOT study in Sweden from 1997 to March 1999 were examined. Their median age (range) was 58 years (1684), and median disease duration 6.0 months. Serum-COMP was analysed at inclusion and after 3 months by ELISA (AnaMar, Lund). Based on changes in serum-COMP over the first 3 months, three subgroups of patients were defined: unchanged serum-COMP levels (change <= 20%) (group UNCh), increasing levels (increase > 20%) (group INCr) and decreasing levels (decrease > 20 %) (group DECr).Radiographs of hands and feet were obtained at inclusion and after 5 years and scored by the van der Heijde modification of the Sharp (SHS) method. The smallest detectable change in SHS was 5.8. Radiographic progression was defined as a change of total score of 5.8 or more.
For all patients the median (range) serum COMP level at inclusion was 12.7 U/L (4.532.0). Group UNCh, with no change in serum-COMP consisted of 142 (41%) patients, group INCr, with increasing levels consisted of 34 (10%) patients and group DECr with decreasing COMP-levels of 172 (49%) patients. Group INCr had an increased risk of radiographic joint damage progression (total SHS) compared with group UNCh, OR 2.8 (95% CI 1.266.38), p=0.011. Group DECr did not differ in this respect from group UNCh. After 5 years the patients in group INCr had higher erosion score compared to the other groups, figure 1. There were no significant differences between the groups regarding JSN score (p=0.19) or total Sharp score (p=0.07). Group INCr had the lowest levels of serum-COMP at baseline compared with the other groups, p<0.01 and higher ESR than group DECr, 42 (2140) vs. 27 (2115), p=0.02. There were no differences between the groups at inclusion regarding age, gender, disease duration, DAS28, HAQ or CRP.
Early increase in serum-COMP in RA patients suggesting altered activity in the process of pathological cartilage turnover was in this study associated with joint damage progression over a 5 year period. These findings merit further studies to clarify whether early changes in serum-COMP may contribute to the clinician's assessment of prognosis.
To cite this abstract, please use the following information:
Saxne, Tore, Heinegard, Dick, Forslind, Kristina, Albertsson, Kristina, Hafstrom, Ingiald, Petersson, Ingemar F., et al; Early Increase In Serum-COMP Is Associated with Joint Damage Progression Over the First Five Years In Patients with Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :348