Like a reflection of articular disease activity between T0 and T1, we also calculated the mean DAS28-ESR and the mean CRP of all of the ideals recorded in the monitoring appointments conducted during this period of time. Statistical analysis The sample was described by using summary statistics, i.e., the mean, Resminostat median, standard deviation, and interquartile range for quantitative variables and distribution percentages Resminostat for qualitative variables. Crude associations between the presence of Resminostat radiographic progression expressed inside a dichotomous variable (progression / no progression) and clinical and laboratory variables were investigated by bivariate logistic regression models, expressing the results as an odds ratios (OR) and significance value. A multivariate logistic regression analysis was performed to assess the predictive part of the OPG and DKK-1 levels on radiological progression, controlling for potential confounders such as age, sex, disease activity, mean corticosteroid dose, and DMARD treatment duration. disease duration was 1.6 1.5 years. Most individuals were seropositive for either RF or ACPA, and the large majority (76%) were in remission or experienced low disease activity. After a median follow-up time of 3.3 1.5 years (range, 1C7.5 yrs.), the mean total SHS annual progression Goat polyclonal to IgG (H+L)(PE) was 0.88 2.20 units. Fifty-two percent of the individuals had no progression (defined as a total SHS of zero). The mean serum OPG level did not switch significantly over the study period (from 3.9 1.8 to 4.07 2.23 pmol/L), whereas the mean serum DKK-1 level decreased, although not significantly (from 29.9 10.9 to 23.6 18.8 pmol/L). In the multivariate analysis, the predictive factors increasing the likelihood of total SHS progression were age (OR per year = 1.10; = 0.003) and a high mean C-reactive protein level over the study period (OR Resminostat = 1.29; = 0.005). Circulating OPG showed a protective effect reducing the likelihood of joint space narrowing by 60% (95% CI: 0.38C0.94) and the total SHS progression by 48% (95% CI: 0.28C0.83). The DKK-1 levels were not associated with radiological progression. Summary In individuals with tightly controlled RA, serum OPG was inversely associated with progression Resminostat of joint damage. This biomarker may be useful in combination with additional risk factors to improve prediction in individuals in medical remission or low disease activity state. Introduction In rheumatoid arthritis (RA), remission or low disease activity can be achieved with limited control of swelling and early use of disease-modifying antirrheumatic providers (DMARD). The importance of the treat-to-target strategy (T2T) has recently been highlighted by EULAR recommendations [1,2]. However, the meanings of remission relating to clinical criteria, including disease activity score (DAS), simplified disease activity index (SDAI), and ACR/EULAR Boolean criteria do not constantly correspond with the complete absence of swelling as measured by sensitive imaging techniques, such as magnetic resonance imaging (MRI) or ultrasonography (US) [3C6]. Several studies have shown the presence of subclinical swelling in a significant number of individuals who were considered to be in medical remission or at a low state of disease activity [3,6C8]. This prolonged subclinical joint activity ultimately lead to radiographic joint damage progression [3,6C8]. Several predictors of medical end result and radiographic progression have been proposed in RA, including traditional inflammatory markers (ESR and C-reactive protein), individuals characteristics, and genetic, serologic and imaging biomarkers [9C12]. Among serological biomarkers, recent works possess suggested that some bone redesigning markers may be self-employed predictors of joint damage in RA [9,13C15]. If the level of a bone redesigning biomarker or, particularly the short-term switch in the level, may forecast radiographic progression, these markers may constitute disease activity signals and may also become useful for clinicial controlling of individual individuals. The characteristic trait of RA is definitely a persistent swelling of the synovial membrane and the formation of an invasive synovial tissue, called the pannus, that invades and destroys the adjacent cartilage and subchondral bone. The Receptor Activator of Nuclear Element Kappa B Ligand (RANKL), osteoprotegerin (OPG) and Dickkopf-1 (DKK-1) have been demonstrated to be key molecules involved in bone erosion and bone redesigning [16,17]. The aim of the present study was to test whether these three bone redesigning biomarkers may serve as predictors of radiographic progression in individuals with tightly controlled RA. Methods Study human population An observational longitudinal prospective study was carried out. A total of 97 individuals with RA meeting the 2010 classification criteria for RA [18] were included. All individuals were treated in the Early Arthritis Medical center of Bellvitge Hospital from the same rheumatologist (JN). They were treated relating to a treat-to-target strategy (T2T) aimed at remission (DAS28 2.6). Individuals were in the beginning handled with a single synthetic DMARD, primarily methotrexate (MTX) or leflunomide (LEF), followed by a synthetic DMARD combination (usually MTX and LEF), and an exchange of LEF with biologic providers in case of failure. The study was authorized by the Clinical Study Ethics Committee of Bellvitge University or college Hospital-IDIBELL; Ref:PR/16511). All individuals provided a written educated consent before participating.