title: Anti-CCP antibodies are not a marker of severity in established rheumatoid arthritis: a magnetic resonance imaging study.
abstract: BACKGROUND
  The presence of anti-CCP is an important prognostic tool of rheumatoid arthritis (RA). But research is still ongoing on its relationship with disease activity and functional capacity.
  
  
  OBJECTIVE
  To study the relationship between anti-CCP and disease activity, functional capacity and structural damage indexes, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in cases of established RA.
  
  
  METHODS
  Cross-sectional study with RA patients with 1-10 years of disease duration. Participants underwent clinical evaluation with anti-CCP. Disease activity was assessed using the Clinical Disease Activity Index (CDAI), and functional capacity through the Health Assessment Questionnaire (HAQ). CR analysis was carried out by the Sharp van der Heijde index (SvdH), and MRI analysis by RAMRIS (Rheumatoid Arthritis Magnetic Resonance Image Scoring).
  
  
  RESULTS
  We evaluated 56 patients, with a median (IqR) age of 55 (47.5-60.0) years; 50 (89.3%) participants were female and 37 (66.1%) were positive for anti-CCP. Medians (IqR) of CDAI, HAQ, SvdH and RAMRIS were 14.75 (5.42-24.97) 1.06 (0.28-1.75), 2 (0-8) and 15 (7-35), respectively. There was no association between anti-CCP and CDAI, HAQ and SvdH and RAMRIS scores.
  
  
  CONCLUSIONS
  Our results have not established an association of anti-CCP with the severity of disease. To date, we cannot corroborate anti-CCP as a prognostic tool in patients with established RA.
authors.affiliation: Serviço de Reumatologia, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brasil; Programa de Saúde do Adulto, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil. Electronic address: Lilianssporto@gmail.com.
authors.forename: Lílian Santuza Santos
authors.initials: LS
authors.lastname: Porto
authors.affiliation: Serviço de Radiologia do Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil; Programa de Cirurgia e Oftalmologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
authors.forename: Wilson Campos
authors.initials: WC
authors.lastname: Tavares Júnior
authors.affiliation: Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil; Programa de Saúde Pública, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
authors.forename: Dário Alves da Silva
authors.initials: DA
authors.lastname: Costa
authors.affiliation: Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
authors.forename: Cristina Costa Duarte
authors.initials: CC
authors.lastname: Lanna
authors.affiliation: Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
authors.forename: Adriana Maria
authors.initials: AM
authors.lastname: Kakehasi
keywords: Anti‐CCP; Atividade de doença; Capacidade funcional; Dano estrutural; Disease activity; Functional capacity; Structural damage