Radiographic progression of cervical lesions in patients with rheumatoid arthritis receiving infliximab treatment

Abstract

We evaluated radiographic change in the cervical lesions of 47 RA patients receiving continuous infliximab therapy for at least 1 year. Infliximab treatment had been initiated between November 2003 and December 2007. Patients who were progressive and non-progressive in terms of RA cervical lesions were compared. Matrix metalloproteinase 3 (MMP3) values improved significantly only in non-progressive patients within the 1-year treatment window. Cervical lesion progression was suppressed in 19 of the 23 patients (83%) showing a good response to infliximab treatment and occurred in 16 of the 24 patients (67%) showing a moderate response. This difference was shown to be significant by the Fisher’s exact test (p = 0.002). In the well-responding patients (n = 23) and moderately responding patients (n = 24), the respective changes in the cervical lesion parameters within 1 year were: atlanto-dental interval, 0.17 ± 0.49 and 0.54 ± 0.58 mm (p = 0.013); spinal cord, −0.17 ± 0.49 and −0.54 ± 0.59 mm (p = 0.025); Ranawat value, −0.09 ± 0.29 and −0.42 ± 0.65 mm (p = 0.032). Based on these results, we conclude that infliximab treatment can be used to suppress the progression of rheumatoid arthritis (RA) cervical lesions. It is possible that response to infliximab and MMP3 values can be used to predict the progression of these cervical lesions.

Keywords::

• Cervical lesions
• Infliximab
• Radiographic progression
• Rheumatoid arthritis