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ABSTRACT
The aim of our study was to assess the relationship between bone and cartilage remodeling biomarkers and joint damage in Rheumatoid Arthritis (RA), and to detect whether they have the capacity to predict the progression of joint disease assessment by computed tomography (CT) erosion score. We analyzed 65 female patients with established RA in our Rheumatology Department. Serum levels of bone and cartilage markers were measured: osteocalcin (OC), N-propeptide of type I collagen (PINP), collagen type I and II, C-telopeptide (CTX I, CTX-II) and cartilage oligomeric matrix protein (COMP). Radiography of both wrist and MCP joints were available. Two expert-readers independently scored articular damage and progression using the High-resolution low dose CT scan in a blinded fashion. 65 female patients with established RA with a median age of 44 years were included. The median disease-duration was two years and the median (Disease activity score) DAS 28 score at 4.46 [2.65-7.36]. The percentage of patient with low disease activity was 13.8%, while 55.4 and 30.8% for those with moderate and high disease activity respectively. The resorption bone markers were high in active versus non-active RA. Wrist and MCP erosion scores were also associated with RA activity. Our study shows that biomarkers of bone and cartilage collagen breakdown were related to specific joint erosion in RA and could predict subsequent radiographic damage in RA. Further larger scale longitudinal studies maybe needed to confirm our data.
ARTICLE HISTORY
Received 21 May 2018
Accepted 9 August 2018
KEYWORDS
RA, biomarkers, CT
1. Background
Rheumatoid arthritis (RA) is a chronic connective tissue disease with a worldwide prevalence around 1% [1]. It is associated with progressive disability, systemic complications, early death, and heavy socioeconomic costs [2]. It is characterized by a polyarticular inflammation affecting large and small joints, especially those of the hands. This inflammatory process caused by the synovitis leads to swollen and painful joints and then potential articular destruction, mostly with production of autoantibodies: rheumatoid factor (RF) and anti-citrullinated protein antibody (antiCCP). Consequently, alteration of articular cartilage and bone erosions induce impaired joint function which occurs mainly in the first two years of disease evolution [3-5].
Conventional radiographs (CR) and ultrasound (US) are widely performed for assessing structural joint damage associated with (RA). However, these methods are...