摘要
目标
研究手部OA患者的泼尼松治疗是否调节了生物标志物，以及它们是否可以预测对泼尼松的反应。
方法
在78名患者的血清中测量了反映组织转换和炎症的生物标志物[聚集蛋白聚糖酶衍生的arggecan新表位（ARGS）、MMP衍生的I型胶原新表位、MMP派生的III型胶原新表位（C3M）、真正的V型胶原形成标志物（PROC5）、MMP-衍生的CRP新表位患有疼痛的炎症性手部OA的患者，随机分为泼尼松龙或安慰剂治疗。基线生物标志物水平与疾病特征的相关性[视觉模拟评分（VAS）疼痛、滑膜增厚超声总评分和侵蚀性OA]和OMERACT国际骨关节炎研究协会（OARSI）6年后的反应 周进行线性或逻辑回归分析，并根据年龄、BMI和性别进行调整。6年后生物标志物水平的变化 通过线性回归评估周数，并对基线生物标志物水平、年龄、BMI和性别进行调整。
后果
对于所有患者（平均年龄64岁 年龄，79%为女性），在基线时，生物标志物水平与VAS手指疼痛或滑膜增厚评分之间没有关联。侵蚀性手OA患者的C1M和hsCRP水平较高[调整后的几何平均比分别为1.24（95%CI 1.03，1.49）和1.91（1.19，3.06）]。生物标志物水平并没有随着时间的推移而下降。除了CRPM[几何平均比值为0.88（0.77，1.00）]外，基线生物标志物水平与OARSI反应之间没有关联。
结论
侵蚀性疾病与较高水平的C1M和hsCRP有关。生物标志物水平不受泼尼松龙治疗的影响。目前的生物标志物与手部OA患者对泼尼松龙的反应无关。
Abstract
Objectives
To investigate whether biomarkers are modulated by prednisolone treatment in patients with hand OA and whether they can predict response to prednisolone.

Methods
Biomarkers reflecting tissue turnover and inflammation [aggrecanase-derived neoepitope of arggecan (ARGS), MMP-derived neoepitope of type I collagen (C1M), MMP-derived neoepitope of type III collagen (C3M), marker of true type V collagen formation (PROC5), MMP-derived neoepitope of CRP (CRPM), citrullinated vimentin fragment (VICM), high-sensitivity (hsCRP)] were measured in sera from 78 patients with painful inflammatory hand OA, who were randomized between prednisolone or placebo treatment. Association of baseline biomarker levels with disease characteristics [visual analogue scale (VAS) pain, synovial thickening ultrasonography sum score and erosive OA] and OMERACT-Osteoarthritis Research Society International (OARSI) response after 6 weeks were analysed with linear or logistic regression and adjusted for age, BMI and sex. Change in biomarker levels after 6 weeks was assessed with linear regression adjusted for baseline biomarker levels, age, BMI and sex.

Results
For all patients (mean age 64 years, 79% female), there were no associations between biomarker levels and VAS finger pain or synovial thickening score at baseline. Patients with erosive hand OA had higher levels of C1M and hsCRP [adjusted geometric mean ratio 1.24 (95% CI 1.03, 1.49) and 1.91 (1.19, 3.06), respectively]. Biomarker levels did not decrease over time. There was no association between baseline biomarkers levels and OARSI response, except for CRPM [geometric mean ratio of 0.88 (0.77, 1.00)].

Conclusion
Erosive disease was associated with higher levels of C1M and hsCRP. Biomarker levels were not influenced by treatment with prednisolone. Current biomarkers were not associated with response to prednisolone in hand OA.

https://academic.oup.com/rheumatology/article/62/3/1350/6659532?login=false