Diagnosis and treatment of rheumatoid arthritis are quite challenging tasks.
Activity and outcome scores like DAS, DAS28, SDAI or CDAI, Larsen Score, etc. are commonly used but are time consuming and not practical in the early phase of rheumatoid arthritis (RA). Moreover, no validated or accepted uniform criteria exist to classify individuals with early RA in terms of disease progression and severity. Even if CCP has been added to the 2010 ACR criteria for diagnostic purposes, its usefulness as a marker for disease activity and progression is still under discussion. But this information is exactly what is needed to choose the appropriate therapy because not all early disease patients are candidates for DMARD or biological therapy, mainly due to toxicity reasons. Aggressive therapy is recommended only for those who are at risk of rapid joint destruction.
Therefore, there is need for prognostic markers that can predict the risk of bone erosions development in RA patients and help make therapeutic decisions.
To overcome this problem, AESKU.DIAGNOSTICS offers a new activity and early prognostic marker for RA - the matrix metalloproteinase (MMP)-3.
MMP-3 is thought to be a key player in cartilage destruction and bone degradation. Expression of MMP-3 is considerably enhanced in RA. The synovial fluid from RA patients contains high levels of MMP-3. Serum levels of RA patients are also strongly elevated and correlate with the amount of MMP-3 in the synovial fluid.
MMP-3 has been shown to predict bone erosions in early phase RA patients 6 to 12 months in advance. Moreover, it helps to monitor disease activity, offering a faster and cheaper option to the assessment of clinical activity than using activity scores such as DAS, DAS28, SDAI or CDAI. The detection of MMP-3 helps to discriminate patients that benefit from aggressive drug therapy. Valuable time and costs can be saved, since patients can receive the appropriate therapy in an early disease progression stage.
AESKULISA MMP-3 is a solid phase enzyme immunoassay with two different monoclonal antibodies against human MMP-3 for the quantitative determination of the MMP-3 concentration in human serum.
The test is used to assess the risk of developing joint destruction and to monitor the activity of RA. Due to its multifaceted informative value MMP-3 helps physicians to create and adapt an individualized drug therapy for each patient.
References
Yamanaka, H. et al. (2000) Serum matrix metalloproteinase 3 as a predictor of the degree of joint destruction during the six months after measurement, in patients with early rheumatoid arthritis. Arthritis Rheum. 43, 852-858
Posthumus, M.D. et al. (2002) Serum matrix metalloproteinase 3 levels during treatment with sulfasalazine or combination of methotrexate and sulfasalazine in patients with early rheumatoid arthritis. J. Rheumatol. 29, 883-889
Green, M.J. et al. (2003) Serum MMP-3 and MMP-1 and progression of joint damage in early rheumatoid arthritis. Rheumatology. (Oxford) 42, 83-88
Fiedorczyk, M. et al. (2006) Serum matrix metalloproteinases and tissue inhibitors of metalloproteinases in patients with early rheumatoid arthritis. J. Rheumatol. 33, 1523-1529
Shinozaki, M. et al. (2007) Elevation of serum matrix metalloproteinase-3 as a predictive marker for the long-term disability of rheumatoid arthritis patients in a prospective observational cohort IORRA. Mod. Rheumatol. 17, 403-408
Houseman, M. et al. (2012) Baseline serum MMP-3 levels in patients with rheumatoid arthritis are still independently predictive of radiographic progression in a longitudinal observational cohort at 8 years follow up. Arthritis Resaearch & Therapy 14: R30