Limits...
Levels of anti-citrullinated protein antibodies and IgM rheumatoid factor are not associated with outcome in early arthritis patients: a cohort study.

Ursum J, Bos WH, van Dillen N, Dijkmans BA, van Schaardenburg D - Arthritis Res. Ther. (2010)

Bottom Line: Level changes were not associated with the outcome parameters.Baseline levels and first-year changes of ACPA and IgM-RF are hardly associated with outcome after two years.Therefore, it does not appear useful to repeat ACPA or IgM-RF measurements.

View Article: PubMed Central - HTML - PubMed

Affiliation: Jan van Breemen Institute, department of rheumatology, Dr, Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands.

ABSTRACT

Introduction: To investigate whether baseline levels of anti-citrullinated protein antibody (ACPA) or IgM rheumatoid factor (IgM-RF) and changes in the year thereafter are associated with disease activity, functional and radiographic outcome in early arthritis patients, and provide additional information over baseline autoantibody status.

Methods: In 545 early arthritis patients ACPA and IgM-RF levels, disease activity (DAS28), the Health Assessment Questionnaire (HAQ) and Sharp/Van der Heijde Score (SHS) were assessed annually. Baseline status, levels and first-year changes of the autoantibodies were associated with these measures at the two-year follow-up and sub-analysed according to autoantibody status.

Results: The mean age was 52.7 years, 69% was female, at baseline 56% was ACPA positive, 47% IgM-RF positive. At the two-year follow-up the mean DAS28 was 2.88, and the median HAQ and SHS were 0.38 and 1, respectively. At one year, ACPA and IgM-RF levels had decreased by 31% and 56%, respectively. A switch from negative to positive occurred in 2% for ACPA and 3% for IgM-RF. Positive ACPA and RF status were both associated with SHS at two years (P < 0.001), but baseline levels only showed a minor correlation of ACPA with DAS28 and HAQ at two years. Level changes were not associated with the outcome parameters.

Conclusions: Baseline levels and first-year changes of ACPA and IgM-RF are hardly associated with outcome after two years. Seroconversion seldom occurs. Therefore, it does not appear useful to repeat ACPA or IgM-RF measurements.

Show MeSH

Related in: MedlinePlus

Absolute change of IgM-RF and ACPA compared with the absolute change of DAS28, HAQ and SHS. The x-axes of a, c and f represent change in anti-citrullinated protein antibody (ACPA) levels in the first year. The x-axes of b, d and e represent the change in IgM-rheumatoid factor (RF) levels in the first year. Negative numbers indicate a decrease in levels whereas a positive number indicates an increase in levels. The Y-axes of a and b represent the change in the Disease Activity Score on 28 joints (DAS28) in the first year. The Y-axes of c and d represent the change in the Health Assessment Score (HAQ) in the first year. The Y-axes of e and f represent the change in the Sharp/van der Heijde Score (SHS) in the first year. Negative numbers indicate a decrease in the score and a positive number an increase, though for the SHS only an increase in score is possible.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2875634&req=5

Figure 1: Absolute change of IgM-RF and ACPA compared with the absolute change of DAS28, HAQ and SHS. The x-axes of a, c and f represent change in anti-citrullinated protein antibody (ACPA) levels in the first year. The x-axes of b, d and e represent the change in IgM-rheumatoid factor (RF) levels in the first year. Negative numbers indicate a decrease in levels whereas a positive number indicates an increase in levels. The Y-axes of a and b represent the change in the Disease Activity Score on 28 joints (DAS28) in the first year. The Y-axes of c and d represent the change in the Health Assessment Score (HAQ) in the first year. The Y-axes of e and f represent the change in the Sharp/van der Heijde Score (SHS) in the first year. Negative numbers indicate a decrease in the score and a positive number an increase, though for the SHS only an increase in score is possible.

Mentions: Absolute or relative changes in ACPA level in the first year were not correlated to DAS28, HAQ or SHS at the two-year follow up (all P > 0.13; Figure 1). First-year changes in IgM-RF level were not correlated to DAS28 and HAQ (Figure 1), but absolute and relative changes were modestly correlated to SHS at two years (r = -0.17 vs. R = -0.15, both P < 0.001). In ACPA or IgM-RF-positive patients, absolute as well as relative changes in levels in the first year were not correlated with the two-year outcome measures (all P > 0.10). ACPA or IgM-RF-negative patients were not further analysed since their levels did not change significantly.


Levels of anti-citrullinated protein antibodies and IgM rheumatoid factor are not associated with outcome in early arthritis patients: a cohort study.

Ursum J, Bos WH, van Dillen N, Dijkmans BA, van Schaardenburg D - Arthritis Res. Ther. (2010)

Absolute change of IgM-RF and ACPA compared with the absolute change of DAS28, HAQ and SHS. The x-axes of a, c and f represent change in anti-citrullinated protein antibody (ACPA) levels in the first year. The x-axes of b, d and e represent the change in IgM-rheumatoid factor (RF) levels in the first year. Negative numbers indicate a decrease in levels whereas a positive number indicates an increase in levels. The Y-axes of a and b represent the change in the Disease Activity Score on 28 joints (DAS28) in the first year. The Y-axes of c and d represent the change in the Health Assessment Score (HAQ) in the first year. The Y-axes of e and f represent the change in the Sharp/van der Heijde Score (SHS) in the first year. Negative numbers indicate a decrease in the score and a positive number an increase, though for the SHS only an increase in score is possible.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875634&req=5

Figure 1: Absolute change of IgM-RF and ACPA compared with the absolute change of DAS28, HAQ and SHS. The x-axes of a, c and f represent change in anti-citrullinated protein antibody (ACPA) levels in the first year. The x-axes of b, d and e represent the change in IgM-rheumatoid factor (RF) levels in the first year. Negative numbers indicate a decrease in levels whereas a positive number indicates an increase in levels. The Y-axes of a and b represent the change in the Disease Activity Score on 28 joints (DAS28) in the first year. The Y-axes of c and d represent the change in the Health Assessment Score (HAQ) in the first year. The Y-axes of e and f represent the change in the Sharp/van der Heijde Score (SHS) in the first year. Negative numbers indicate a decrease in the score and a positive number an increase, though for the SHS only an increase in score is possible.
Mentions: Absolute or relative changes in ACPA level in the first year were not correlated to DAS28, HAQ or SHS at the two-year follow up (all P > 0.13; Figure 1). First-year changes in IgM-RF level were not correlated to DAS28 and HAQ (Figure 1), but absolute and relative changes were modestly correlated to SHS at two years (r = -0.17 vs. R = -0.15, both P < 0.001). In ACPA or IgM-RF-positive patients, absolute as well as relative changes in levels in the first year were not correlated with the two-year outcome measures (all P > 0.10). ACPA or IgM-RF-negative patients were not further analysed since their levels did not change significantly.

Bottom Line: Level changes were not associated with the outcome parameters.Baseline levels and first-year changes of ACPA and IgM-RF are hardly associated with outcome after two years.Therefore, it does not appear useful to repeat ACPA or IgM-RF measurements.

View Article: PubMed Central - HTML - PubMed

Affiliation: Jan van Breemen Institute, department of rheumatology, Dr, Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands.

ABSTRACT

Introduction: To investigate whether baseline levels of anti-citrullinated protein antibody (ACPA) or IgM rheumatoid factor (IgM-RF) and changes in the year thereafter are associated with disease activity, functional and radiographic outcome in early arthritis patients, and provide additional information over baseline autoantibody status.

Methods: In 545 early arthritis patients ACPA and IgM-RF levels, disease activity (DAS28), the Health Assessment Questionnaire (HAQ) and Sharp/Van der Heijde Score (SHS) were assessed annually. Baseline status, levels and first-year changes of the autoantibodies were associated with these measures at the two-year follow-up and sub-analysed according to autoantibody status.

Results: The mean age was 52.7 years, 69% was female, at baseline 56% was ACPA positive, 47% IgM-RF positive. At the two-year follow-up the mean DAS28 was 2.88, and the median HAQ and SHS were 0.38 and 1, respectively. At one year, ACPA and IgM-RF levels had decreased by 31% and 56%, respectively. A switch from negative to positive occurred in 2% for ACPA and 3% for IgM-RF. Positive ACPA and RF status were both associated with SHS at two years (P < 0.001), but baseline levels only showed a minor correlation of ACPA with DAS28 and HAQ at two years. Level changes were not associated with the outcome parameters.

Conclusions: Baseline levels and first-year changes of ACPA and IgM-RF are hardly associated with outcome after two years. Seroconversion seldom occurs. Therefore, it does not appear useful to repeat ACPA or IgM-RF measurements.

Show MeSH
Related in: MedlinePlus