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Rheumatology Advance Access published online on April 9, 2008
Rheumatology, doi:10.1093/rheumatology/ken052
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Value of serum cartilage oligomeric matrix protein as a prognostic marker of large-joint damage in rheumatoid arthritis—data from the RAPIT study

Z. de Jong1, M. Munneke2, V. Vilim3, A. H. Zwinderman4, H. M. Kroon5, H. K. Ronday6, W. F. Lems7, B. A. C. Dijkmans7, F. C. Breedveld1, T. P. M. Vliet Vlieland1, J. M. W. Hazes1,8 and J. DeGroot9

1Department of Rheumatology, Leiden University Medical Center, Leiden, 2Department of Neurology, University Medical Centre St. Radboud, The Netherlands, 3Institute of Rheumatology, Prague, Czech Republic, 4Department of Clinical Epidemiology and Biostatistics, Academic Medical Center University of Amsterdam, Amsterdam, 5Department of Radiology, Leiden University Medical Center, Leiden, 6Leyenburg Hospital, The Hague, 7Department of Rheumatology, Vrije Universiteit Medical Center, Amsterdam, 8Department of Rheumatology, Erasmus University Medical Center, Rotterdam and 9Division of Biomedical Research, TNO Prevention and Health, Leiden, The Netherlands.

Correspondence to: Z. de Jong, Department of Rheumatology C4-R, Leiden University Medical Center, Post-box 9600, 2300 RC Leiden, The Netherlands. E-mail: z.de_jong{at}lumc.nl; zdejong{at}worldonline.nl


  Abstract

Objective. To investigate the utility of serum COMP level measurements as a predictor of future damage of the weight-bearing (large) joints in RA patients participating in intensive exercise.

Methods. Data of the 281 completers of a 2-yr randomized controlled trial (Rheumatoid Arthritis Patients In Training; RAPIT) comparing the effects of usual care physical therapy with high-intensity weight-bearing exercises were analysed. The primary outcome variable was defined as the change in radiological joint damage (Larsen score) of the large joints. Potential predictors of outcome were defined: baseline and change in serum level of COMP after 3 months, baseline radiological damage of the large and small joints, number of months on glucocorticoids, change in disease activity and in physical capacity (aerobic fitness and muscle strength) after 2 yrs, and participation in the exercise group.

Results. In cross-sectional evaluation of baseline data, we found strong association between the high serum COMP level and current damage of the large joints. Serum COMP level at baseline, however, was not associated with an increased rate of radiological joint damage after 2 yrs of follow-up. Furthermore, neither interaction between baseline COMP level and participation in exercises, nor change in COMP level after 3 months of exercising were associated with future damage of the large joints.

Conclusion. Neither baseline serum COMP level nor its individual change after 3 months from start of intensive exercise predict longitudinal progression of damage of the large joints in this population.

KEY WORDS: Cartilage oligomeric matrix protein, Large-joint damage, Intensive exercise, Rheumatoid arthritis

Submitted 18 December 2005; revised version accepted 23 January 2008.
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