Serial determination of cyclic citrullinated peptide autoantibodies predicted five-year radiological outcomes in a prospective cohort of patients with early rheumatoid arthritis.
The objective of this study was to evaluate the potential of serially determined anti-cyclic citrullinated peptide (CCP) antibodies for predicting structural joint damage in patients with early rheumatoid arthritis (RA), compared to a single baseline determination. Ninety-nine RA patients with disease durations of less than one year and no history of disease-modifying antirheumatic drug therapy were followed prospectively for at least five years. Anti-CCP2 concentrations were measured using a second-generation ELISA. Sharp scores as modified by van der Heijde were determined on hand and foot radiographs. Anti-CCP2 antibodies were detected in 55.5% of patients at baseline and 63.6% at any time during the first three years. Presence of anti-CCP2 at any time during the first three years was associated with radiographic damage at baseline (odds ratio (OR), 3.66; 95% confidence interval (95% CI) 0.99-13.54) and with five year progression of the total Sharp score (OR, 3.17; 95% CI, 1.3-7.7), erosion score (OR, 5.3; 95% CI, 1.4-19.2) and joint space narrowing score (OR, 2.8; 95% CI, 1.15-6.8). The presence of anti-CCP2 or IgM RF at baseline did not predict these outcomes. Patients with negative anti-CCP2 tests throughout follow-up had less radiographic progression than patients with increasing anti-CCP2 concentrations; they did not differ from patients with decreasing anti-CCP2 antibody levels. HLADRB1* typing showed that progression of the mean modified Sharp score was not correlated with the presence of the shared epitope alleles. In conclusion, serially determined anti-CCP2 antibodies during the first three years of follow-up performs better than baseline determination for predicting radiographic progression in patients with early RA.
Rheumatology Unit, Assistance Publique Hôpitaux de Paris, Bichat University Hospital, 75018 Paris, France. olivier.meyer@bch.aphp.fr
Olivier
O
Meyer
Pascale
P
Nicaise-Roland
Marie Dos
MD
Santos
Colette
C
Labarre
Maxime
M
Dougados
Philippe
P
Goupille
Alain
A
Cantagrel
Jean
J
Sibilia
Bernard
B
Combe
D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000276:immunology*; D001175:Arthrography; D001323:Autoantibodies / Q000097:blood*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010456:Peptides, Cyclic / Q000276:immunology*; D011237:Predictive Value of Tests; D011446:Prospective Studies
D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide