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Anti-cyclic citrullinated peptide antibody titer predicts time to rheumatoid arthritis onset in patients with undifferentiated arthritis: results from a 2-year prospective study.

Bizzaro N, Bartoloni E, Morozzi G, Manganelli S, Riccieri V, Sabatini P, Filippini M, Tampoia M, Afeltra A, Sebastiani G, Alpini C, Bini V, Bistoni O, Alunno A, Gerli R, Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni (FIRMA Grou - Arthritis Res. Ther. (2013)

Bottom Line: Anti-CCP positivity, at both low and high titer, and arthritis of hand joints significantly predicted RA at two years, risk increasing in subjects with high anti-CCP titers at baseline.Presence of anti-CCP antibodies, at both low and high concentration, is significantly associated with RA development in subjects with recent onset UA.However, time interval from the onset of the first symptoms to the fulfilment of the classification criteria appears to be directly related to the initial anti-CCP level.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: The diagnostic, predictive and prognostic role of anti-cyclic citrullinated peptide (CCP) antibodies in rheumatoid arthritis (RA) patients is widely accepted. Moreover, detection of these antibodies in subjects presenting with undifferentiated arthritis (UA) is associated with a significant risk to develop the disease. On the other hand, clinical and prognostic significance of evaluating anti-CCP levels in subjects with inflammatory arthritis at disease onset has not been fully clarified. The goal of this prospective study is to analyze the value and prognostic significance of anti-CCP titer quantification in UA subjects.

Methods: Serial anti-CCP assays were measured in 192 consecutive patients presenting with UA lasting less than 12 weeks. Clinical and serological data and arthritis outcome were evaluated every 6 months until two years of follow-up.

Results: Anti-CCP positivity, at both low and high titer, and arthritis of hand joints significantly predicted RA at two years, risk increasing in subjects with high anti-CCP titers at baseline. Moreover, time to RA diagnosis was shorter in patients with high anti-CCP2 titers at enrollment with respect to those with low antibody concentration.

Conclusions: Presence of anti-CCP antibodies, at both low and high concentration, is significantly associated with RA development in subjects with recent onset UA. However, time interval from the onset of the first symptoms to the fulfilment of the classification criteria appears to be directly related to the initial anti-CCP level.

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Time to reach rheumatoid arthritis (RA) diagnosis according to anti-cyclic citrullinated peptide 2 (CCP2) levels in 192 patients with undifferentiated arthritis. Data were analyzed by Kaplan-Meier analysis and the log-rank test.
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Figure 1: Time to reach rheumatoid arthritis (RA) diagnosis according to anti-cyclic citrullinated peptide 2 (CCP2) levels in 192 patients with undifferentiated arthritis. Data were analyzed by Kaplan-Meier analysis and the log-rank test.

Mentions: As shown in Figure 1, time from presentation to diagnosis of RA was related to anti-CCP2 levels at baseline, since this period was shorter in patients having high anti-CCP2 titers at enrollment with respect to those displaying basal low anti-CCP2 levels. However, the RA-free survival curve in the two groups overlapped at the end of 2-year follow up.


Anti-cyclic citrullinated peptide antibody titer predicts time to rheumatoid arthritis onset in patients with undifferentiated arthritis: results from a 2-year prospective study.

Bizzaro N, Bartoloni E, Morozzi G, Manganelli S, Riccieri V, Sabatini P, Filippini M, Tampoia M, Afeltra A, Sebastiani G, Alpini C, Bini V, Bistoni O, Alunno A, Gerli R, Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni (FIRMA Grou - Arthritis Res. Ther. (2013)

Time to reach rheumatoid arthritis (RA) diagnosis according to anti-cyclic citrullinated peptide 2 (CCP2) levels in 192 patients with undifferentiated arthritis. Data were analyzed by Kaplan-Meier analysis and the log-rank test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672733&req=5

Figure 1: Time to reach rheumatoid arthritis (RA) diagnosis according to anti-cyclic citrullinated peptide 2 (CCP2) levels in 192 patients with undifferentiated arthritis. Data were analyzed by Kaplan-Meier analysis and the log-rank test.
Mentions: As shown in Figure 1, time from presentation to diagnosis of RA was related to anti-CCP2 levels at baseline, since this period was shorter in patients having high anti-CCP2 titers at enrollment with respect to those displaying basal low anti-CCP2 levels. However, the RA-free survival curve in the two groups overlapped at the end of 2-year follow up.

Bottom Line: Anti-CCP positivity, at both low and high titer, and arthritis of hand joints significantly predicted RA at two years, risk increasing in subjects with high anti-CCP titers at baseline.Presence of anti-CCP antibodies, at both low and high concentration, is significantly associated with RA development in subjects with recent onset UA.However, time interval from the onset of the first symptoms to the fulfilment of the classification criteria appears to be directly related to the initial anti-CCP level.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: The diagnostic, predictive and prognostic role of anti-cyclic citrullinated peptide (CCP) antibodies in rheumatoid arthritis (RA) patients is widely accepted. Moreover, detection of these antibodies in subjects presenting with undifferentiated arthritis (UA) is associated with a significant risk to develop the disease. On the other hand, clinical and prognostic significance of evaluating anti-CCP levels in subjects with inflammatory arthritis at disease onset has not been fully clarified. The goal of this prospective study is to analyze the value and prognostic significance of anti-CCP titer quantification in UA subjects.

Methods: Serial anti-CCP assays were measured in 192 consecutive patients presenting with UA lasting less than 12 weeks. Clinical and serological data and arthritis outcome were evaluated every 6 months until two years of follow-up.

Results: Anti-CCP positivity, at both low and high titer, and arthritis of hand joints significantly predicted RA at two years, risk increasing in subjects with high anti-CCP titers at baseline. Moreover, time to RA diagnosis was shorter in patients with high anti-CCP2 titers at enrollment with respect to those with low antibody concentration.

Conclusions: Presence of anti-CCP antibodies, at both low and high concentration, is significantly associated with RA development in subjects with recent onset UA. However, time interval from the onset of the first symptoms to the fulfilment of the classification criteria appears to be directly related to the initial anti-CCP level.

Show MeSH
Related in: MedlinePlus