title: Association of anticyclic citrullinated peptide antibodies and/or rheumatoid factor status and clinical presentation in early arthritis: results from the ESPOIR cohort.
abstract: OBJECTIVE
  To compare the initial clinical, biological, and radiographic findings of early arthritis by positivity for rheumatoid factor (RF) and/or anticyclic citrullinated peptide antibodies (anti-CCP), and to validate a patient profile based on this serologic information.
  
  
  METHODS
  The ESPOIR cohort comprises patients presenting synovitis of at least 2 joints for 6 weeks to 6 months. Patients underwent testing for IgM rheumatoid factor (IgM-RF) and anti-CCP2 antibodies and were divided into 4 groups: RF- and anti-CCP- (group 1), RF+ and anti-CCP- (group 2), RF- and anti-CCP+ (group 3), RF+ and anti-CCP+ (group 4). We compared the groups in terms of clinical, biological, and radiographic features (baseline scores and 6-month and 12-month progression).
  
  
  RESULTS
  Of the 813 recruited patients, 406 (50%) were in group 1, 91 (11.2%) in group 2, 34 (4.1%) in group 3, and 281 (34.6%) in group 4. Mean baseline erythrocyte sedimentation rate and C-reactive protein were higher for anti-CCP+ groups (groups 3 and 4) than for other groups (p < 0.001), and van der Heijde-modified Sharp score for radiographs was higher for group 4 than for other groups (p < 0.001). Clinical presentation was not consistently associated with serologic profile. Radiographic progression at 1 year was higher for anti-CCP+ groups than other groups (p < 0.001).
  
  
  CONCLUSIONS
  The phenotype of patients with early arthritis with or without anti-CCP and/or RF positivity did not correspond to a particular clinical presentation. However, baseline acute-phase reactants and short-term radiographic progression were high in patients with anti-CCP positivity, which may be associated with the inflammatory process and progressive disease in patients with early arthritis.
authors.affiliation: From the Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535, Montpellier; Department of Rheumatology, University Hospital of Tours; and UMR CNRS 7292, François Rabelais University, Tours; Rheumatology Department, Roger Salengro Hospital, Lille 2 University, Lille; and Biostatistics, Epidemiology and Clinical Research Unit, IURC, Montpellier and Nîmes, France.G. Mouterde, MD, Rheumatologist; C. Lukas, MD, PhD, Rheumatologist; Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University; R.M. Flipo, MD, PhD, Rheumatologist, Rheumatology Department, Roger Salengro Hospital, Lille 2 University; P. Goupille, Rheumatologist, MD, PhD; Department of Rheumatology, University Hospital of Tours; UMR CNRS 7292, François Rabelais University; N. Rincheval, MS2Biostatistics, Biostatistician; J.P. Daurès, MD, PhD, Biostatistician, Biostatistics, Epidemiology and Clinical Research Unit, IURC; B. Combe, MD, PhD, Rheumatologist, Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535.
authors.forename: Gaël
authors.initials: G
authors.lastname: Mouterde
authors.affiliation: From the Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535, Montpellier; Department of Rheumatology, University Hospital of Tours; and UMR CNRS 7292, François Rabelais University, Tours; Rheumatology Department, Roger Salengro Hospital, Lille 2 University, Lille; and Biostatistics, Epidemiology and Clinical Research Unit, IURC, Montpellier and Nîmes, France.G. Mouterde, MD, Rheumatologist; C. Lukas, MD, PhD, Rheumatologist; Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University; R.M. Flipo, MD, PhD, Rheumatologist, Rheumatology Department, Roger Salengro Hospital, Lille 2 University; P. Goupille, Rheumatologist, MD, PhD; Department of Rheumatology, University Hospital of Tours; UMR CNRS 7292, François Rabelais University; N. Rincheval, MS2Biostatistics, Biostatistician; J.P. Daurès, MD, PhD, Biostatistician, Biostatistics, Epidemiology and Clinical Research Unit, IURC; B. Combe, MD, PhD, Rheumatologist, Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535.
authors.forename: Cédric
authors.initials: C
authors.lastname: Lukas
authors.affiliation: From the Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535, Montpellier; Department of Rheumatology, University Hospital of Tours; and UMR CNRS 7292, François Rabelais University, Tours; Rheumatology Department, Roger Salengro Hospital, Lille 2 University, Lille; and Biostatistics, Epidemiology and Clinical Research Unit, IURC, Montpellier and Nîmes, France.G. Mouterde, MD, Rheumatologist; C. Lukas, MD, PhD, Rheumatologist; Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University; R.M. Flipo, MD, PhD, Rheumatologist, Rheumatology Department, Roger Salengro Hospital, Lille 2 University; P. Goupille, Rheumatologist, MD, PhD; Department of Rheumatology, University Hospital of Tours; UMR CNRS 7292, François Rabelais University; N. Rincheval, MS2Biostatistics, Biostatistician; J.P. Daurès, MD, PhD, Biostatistician, Biostatistics, Epidemiology and Clinical Research Unit, IURC; B. Combe, MD, PhD, Rheumatologist, Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535.
authors.forename: Philippe
authors.initials: P
authors.lastname: Goupille
authors.affiliation: From the Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535, Montpellier; Department of Rheumatology, University Hospital of Tours; and UMR CNRS 7292, François Rabelais University, Tours; Rheumatology Department, Roger Salengro Hospital, Lille 2 University, Lille; and Biostatistics, Epidemiology and Clinical Research Unit, IURC, Montpellier and Nîmes, France.G. Mouterde, MD, Rheumatologist; C. Lukas, MD, PhD, Rheumatologist; Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University; R.M. Flipo, MD, PhD, Rheumatologist, Rheumatology Department, Roger Salengro Hospital, Lille 2 University; P. Goupille, Rheumatologist, MD, PhD; Department of Rheumatology, University Hospital of Tours; UMR CNRS 7292, François Rabelais University; N. Rincheval, MS2Biostatistics, Biostatistician; J.P. Daurès, MD, PhD, Biostatistician, Biostatistics, Epidemiology and Clinical Research Unit, IURC; B. Combe, MD, PhD, Rheumatologist, Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535.
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.affiliation: From the Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535, Montpellier; Department of Rheumatology, University Hospital of Tours; and UMR CNRS 7292, François Rabelais University, Tours; Rheumatology Department, Roger Salengro Hospital, Lille 2 University, Lille; and Biostatistics, Epidemiology and Clinical Research Unit, IURC, Montpellier and Nîmes, France.G. Mouterde, MD, Rheumatologist; C. Lukas, MD, PhD, Rheumatologist; Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University; R.M. Flipo, MD, PhD, Rheumatologist, Rheumatology Department, Roger Salengro Hospital, Lille 2 University; P. Goupille, Rheumatologist, MD, PhD; Department of Rheumatology, University Hospital of Tours; UMR CNRS 7292, François Rabelais University; N. Rincheval, MS2Biostatistics, Biostatistician; J.P. Daurès, MD, PhD, Biostatistician, Biostatistics, Epidemiology and Clinical Research Unit, IURC; B. Combe, MD, PhD, Rheumatologist, Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rincheval
authors.affiliation: From the Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535, Montpellier; Department of Rheumatology, University Hospital of Tours; and UMR CNRS 7292, François Rabelais University, Tours; Rheumatology Department, Roger Salengro Hospital, Lille 2 University, Lille; and Biostatistics, Epidemiology and Clinical Research Unit, IURC, Montpellier and Nîmes, France.G. Mouterde, MD, Rheumatologist; C. Lukas, MD, PhD, Rheumatologist; Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University; R.M. Flipo, MD, PhD, Rheumatologist, Rheumatology Department, Roger Salengro Hospital, Lille 2 University; P. Goupille, Rheumatologist, MD, PhD; Department of Rheumatology, University Hospital of Tours; UMR CNRS 7292, François Rabelais University; N. Rincheval, MS2Biostatistics, Biostatistician; J.P. Daurès, MD, PhD, Biostatistician, Biostatistics, Epidemiology and Clinical Research Unit, IURC; B. Combe, MD, PhD, Rheumatologist, Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Daurès
authors.affiliation: From the Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535, Montpellier; Department of Rheumatology, University Hospital of Tours; and UMR CNRS 7292, François Rabelais University, Tours; Rheumatology Department, Roger Salengro Hospital, Lille 2 University, Lille; and Biostatistics, Epidemiology and Clinical Research Unit, IURC, Montpellier and Nîmes, France.G. Mouterde, MD, Rheumatologist; C. Lukas, MD, PhD, Rheumatologist; Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University; R.M. Flipo, MD, PhD, Rheumatologist, Rheumatology Department, Roger Salengro Hospital, Lille 2 University; P. Goupille, Rheumatologist, MD, PhD; Department of Rheumatology, University Hospital of Tours; UMR CNRS 7292, François Rabelais University; N. Rincheval, MS2Biostatistics, Biostatistician; J.P. Daurès, MD, PhD, Biostatistician, Biostatistics, Epidemiology and Clinical Research Unit, IURC; B. Combe, MD, PhD, Rheumatologist, Rheumatology Department, Lapeyronie Hospital, Montpellier 1 University, UMR 5535. b-combe@chu-montpellier.fr.
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001175:Arthrography; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D015331:Cohort Studies; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology*; D010641:Phenotype; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood*; D013585:Synovitis / Q000000981:diagnostic imaging / Q000276:immunology; D013997:Time Factors
chemical_list: D000888:Antibodies, Anti-Idiotypic; D015415:Biomarkers; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor
keywords: ANTI-CCP ANTIBODIES; ANTICITRULLINATED PEPTIDE ANTIBODIES; EARLY ARTHRITIS; RHEUMATOID ARTHRITIS; RHEUMATOID FACTOR