AB1143 The impact of anti-cyclic citrullinated peptide seropositivity on erosion prevalence among patients with rheumatoid arthritis of varying disease duration

Background:High titers of cyclic citrullinated peptide antibodies (anti-CCP) are predictive of poor prognosis in the treatment of rheumatoid arthritis (RA). The 2010 ACR/EULAR classification criteria for early RA assign a high point value to cases having highly positive anti-CCP titers. Previous reports have claimed that osteoarthritic damage is more severe and advanced in RA patients who test positive for anti-CCP than in their negative counterparts.Objectives:To retrospectively investigate whether anti-CCP titers were associated with the extent of osteoarthritic damage in RA patients treated at our institution.Methods:Data were analyzed for 422 RA patients who received biologic agents due to resistance to methotrexate or other conventional antirheumatic drugs. Associations were explored between joint replacement history-i.e. total knee replacement (TKR), total hip replacement (THR), or lack thereof—and anti-CCP positivity rates and titers.Results:The sample consisted of 90 men and 332 women. On average, patients were put on biologics at 58.6 years of age (range: 22–85), and had a disease duration of 9.3 years. The first biologic agent chosen was infliximab (IFX) in 154 cases, etanercept (ETN) in 76, adalimumab (ADA) in 61, tocilizumab (TCZ) in 70, abatacept (ABT) in 41, golimumab (GLM) in 18, and certolizumab pegol (CZP) in 2. In total, 331/422 patients (78.4%) tested positive for anti-CCP. TKR was performed in 46 cases (M:F ratio: 7:39, mean age: 64.7 y, mean disease duration: 15.1 y), of which 46 were positive for anti-CCP (100%). THR was performed in 18 cases (M:F ratio: 2:16, mean age: 62.3 y, mean disease duration: 18.5 y), of which 17 were positive for anti-CCP (94.4%). The mean anti-CCP titer among all positive patients (n=331) was 152.9 IU/ml. This value was significantly higher in patients who underwent either joint replacement procedure than those who did not (215.4 v. 142.8 IU/ml, p<0.0005).Conclusion:With one exception, all RA patients who underwent joint replacement were positive for anti-CCP, and their titers were higher than non-surgical cases. Practitioners should be aware of this trend, and pay attention to the progression of damage in the knee and hip joints when treating RA patients with high anti-CCP titers.Disclosure of Interests:None declared

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Anti-Cyclic Citrullinated Peptide (Anti-CCP) and Anti-Mutated Citrullinated Vimentin (Anti-MCV) Relation with Extra-Articular Manifestations in Rheumatoid Arthritis

Journal of Immunology Research ◽

10.1155/2014/536050 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 12

Author(s):

Laura Gonzalez-Lopez ◽

Alberto Daniel Rocha-Muñoz ◽

Manuel Ponce-Guarneros ◽

Alejandra Flores-Chavez ◽

Mario Salazar-Paramo ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Duration ◽

Health Assessment ◽

Serum Levels ◽

Chronic Anemia ◽

Cyclic Citrullinated Peptide ◽

Citrullinated Vimentin ◽

Citrullinated Peptide ◽

Assessment Questionnaire ◽

Questionnaire Disability

We evaluated the association between anti-cyclic citrullinated peptide antibodies (anti-CCP) and anti-mutated citrullinated vimentin antibodies (anti-MCV) with the presence of extra-articular (ExRA) manifestations in 225 patients with rheumatoid arthritis (RA). Ninety-five patients had ExRA and 130 had no ExRA. There was no association of anti-CCP and anti-MCV levels with the presence of ExRA as total group (P=0.40andP=0.91, resp.). Making an analysis of individual manifestations, rheumatoid nodules were associated with positivity for rheumatoid factor (RF); (P=0.01), anti-CCP (P=0.048), and anti-MCV (P=0.02). Instead, RF, anti-CCP, or anti-MCV were not associated with SS, chronic anemia, or peripheral neuropathy. Levels of anti-CCP correlated with the score of the Health Assessment Questionnaire-Disability Index (HAQ-Di) (r=0.154,P=0.03), erythrocyte sedimentation rate (ESR); (r=0.155,P=0.03), and RF (P=0.254,P<0.001), whereas anti-MCV titres only correlated with RF (r=0.169,P=0.02). On adjusted analysis, ExRA was associated with longer age (P=0.015), longer disease duration (P=0.007), higher DAS-28 score (P=0.002), and higher HAQ-DI score (P=0.007), but serum levels of anti-CCP and anti-MCV were not associated. These findings show the need to strengthen the evaluation of the pathogenic mechanisms implied in each specific ExRA manifestation.

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Association of rheumatoid arthritis treatment response and disease duration with declines in serum levels of IgM rheumatoid factor and anti-cyclic citrullinated peptide antibody

Arthritis & Rheumatism ◽

10.1002/art.20659 ◽

2004 ◽

Vol 50 (12) ◽

pp. 3776-3782 ◽

Cited By ~ 71

Author(s):

T. R. Mikuls ◽

J. R. O'Dell ◽

J. A. Stoner ◽

L. A. Parrish ◽

W. P. Arend ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Rheumatoid Factor ◽

Treatment Response ◽

Disease Duration ◽

Serum Levels ◽

Cyclic Citrullinated Peptide ◽

Rheumatoid Arthritis Treatment ◽

Igm Rheumatoid Factor ◽

Peptide Antibody ◽

Citrullinated Peptide

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The impact of anti-cyclic citrullinated peptide antibody status on the management of patients with early rheumatoid arthritis: observational study results from Lithuania

Acta medica Lituanica ◽

10.6001/actamedica.v25i2.3765 ◽

2018 ◽

Vol 25 (2) ◽

pp. 112-123

Author(s):

Sigita Stropuvienė ◽

Asta Baranauskaitė ◽

Loreta Bukauskienė ◽

Jolanta Zaikauskienė

Keyword(s):

Rheumatoid Arthritis ◽

Decision Making ◽

Observational Study ◽

Health Assessment ◽

Cyclic Citrullinated Peptide ◽

Therapeutic Decisions ◽

Peptide Antibody ◽

Study Results ◽

The Impact ◽

Citrullinated Peptide

Background. To provide data on the use of anti-cyclic citrullinated peptide antibody (anti-CCP) and other routinely used clinical parameters and to assess the impact of anti-CCP status on therapeutic decisions, an observational study was conducted in patients with rheumatoid arthritis (RA). Methods. Sixty-seven adult patients with a recent diagnosis of RA were recruited from four rheumatology centres in Lithuania and were prospectively observed for 12 months. Data collection was based on the review of medical records and routine examination of patients. Patients completed the Health Assessment Questionnaire – Disability Index and Patient Global Assessment of disease activity using a visual analogue scale. Physicians were asked about the importance of the anti-CCP results and other factors important for therapeutic decisions. Results. Of the 67 patients enrolled, 54 (80.6%) completed the study. At the beginning of the study, physicians considered anti-CCP results to be important for decision-making in 87.0% of patients. The perceived importance of anti-CCP results did not change significantly throughout the study. After one year of treatment, factors that were considered more important than the anti-CCP results included the presence of erosions, significantly increased C-reactive protein, duration of morning stiffness, multi-articular expanding, and rheumatoid factor status. For nearly half of the patients (n = 26; 48.1%), physicians would not change the treatment strategy if the patient had the opposite anti-CCP results at baseline. Conclusions. The study revealed that decision-making in the management of RA was based on multifactorial data. The role of anti-CCP as a single test in treatment decisions needs further investigation.

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