Abstract
We conducted a review of patients with rheumatoid arthritis who were able to discontinue treatment with biologic agents after achieving clinical remission. For assessment of the effect of biologic agents, the improvement ratio of MMP-3 was evaluated, as well as DAS28. The MMP-3 improvement ratio is calculated as the MMP-3 value after induction of biologic agents devided by the MMP-3 value just before starting biologic agents. The MMP-3 improvement ratio showed a very close correlation with the improvement of DAS28, and its decrease sensitively paralleled the amelioration of clinical symptoms, even after DAS28 had reached the remission level and no decrease was demonstrated. All of the patients were judged to no longer require biologic agents when DAS28 had fallen below 1.8 and the MMP-3 improvement ratio had fallen below 0.4 continuously for more than six months. All of the patients maintained tight disease control after discontinuation. The present findings suggest that MMP-3 is a very useful index for evaluation of rheumatoid arthritis control, and that its improvement ratio can be used to judge whether biologic agents can be dincontinued.
