The role of anti-citrullinated protein antibody reactivities in an inception cohort of patients with rheumatoid arthritis receiving treat-to-target therapy

Abstract In this commentary we discuss the potential of advanced imaging, particularly Dynamic Contrast Enhanced (DCE) magnetic resonance imaging (MRI) for the objective assessment of disease progression in rheumatoid arthritis (RA). We emphasise the potential DCE-MRI in advancing the field and exploring new areas of research and development in RA. We believe that different grades of bone marrow edema (BME) and synovitis in RA can be examined and monitored in a more sensitive manner with DCE-MRI. Future treatments for RA will be significantly improved by enhanced imaging of BMEs and synovitis. DCE-MRI will also facilitate enhanced stratification and phenotyping of patients enrolled in clinical trials.

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Comment on “The Role of Citrullinated Protein Antibodies in Predicting Erosive Disease in Rheumatoid Arthritis: A Systematic Literature Review and Meta-Analysis”

International Journal of Rheumatology ◽

10.1155/2015/175251 ◽

2015 ◽

Vol 2015 ◽

pp. 1-2

Author(s):

Shailendra Kapoor

Keyword(s):

Rheumatoid Arthritis ◽

Literature Review ◽

Systematic Literature Review ◽

Meta Analysis ◽

Erosive Disease ◽

Citrullinated Protein

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Erosions in the foot at baseline are predictive of orthopaedic shoe use after 10 years of treat to target therapy in patients with recent onset rheumatoid arthritis

Clinical Rheumatology ◽

10.1007/s10067-015-3145-1 ◽

2015 ◽

Vol 35 (8) ◽

pp. 2101-2107 ◽

Cited By ~ 2

Author(s):

Sytske Anne Bergstra ◽

Iris M. Markusse ◽

Gülşah Akdemir ◽

H. Karel Ronday ◽

K. Huub Han ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Target Therapy ◽

Treat To Target ◽

Recent Onset

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Calprotectin as a marker of inflammation in patients with early rheumatoid arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-211695 ◽

2017 ◽

Vol 76 (12) ◽

pp. 2031-2037 ◽

Cited By ~ 22

Author(s):

Maria Karolina Jonsson ◽

Nina Paulshus Sundlisæter ◽

Hilde Haugedal Nordal ◽

Hilde Berner Hammer ◽

Anna-Birgitte Aga ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Treatment Response ◽

Radiographic Progression ◽

Activity Index ◽

Inflammatory Marker ◽

Target Therapy ◽

Power Doppler ◽

Treat To Target ◽

Symptom Duration

ObjectivesCalprotectin is an inflammatory marker of interest in rheumatoid arthritis (RA). We evaluated whether the level of calprotectin was associated with disease activity, and if it was predictive of treatment response and radiographic progression in patients with early RA.MethodsPlasma from disease-modifying antirheumatic drug (DMARD)-naïve patients with RA fulfilling 2010 American College of Rheumatology/European League Against Rheumatism classification criteria with symptom duration <2 years was analysed for calprotectin at baseline, and after 1, 3 and 12 months. All patients received treat-to-target therapy, as part of a randomised controlled strategy trial (ARCTIC). The association between calprotectin, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) and measures of disease activity were assessed by correlations. We used likelihood ratios and logistic regression models to assess the predictive value of the baseline inflammatory markers for treatment response and radiographic damage.Results215 patients were included: 61% female, 82% anti-citrullinated peptide antibody positive, mean (SD) age 50.9 (13.7) years and median (25, 75 percentile) symptom duration 5.8 (2.8, 10.5) months. Calprotectin was significantly correlated with Clinical Disease Activity Index (r=0.32), ESR (r=0.50) and ultrasonography power Doppler (r=0.42) before treatment onset. After 12 months of treatment, calprotectin, but not ESR and CRP, was significantly correlated with power Doppler (r=0.27). Baseline levels of calprotectin, ESR and CRP were not predictive of treatment response, but high levels of calprotectin were associated with radiographic progression in multivariate models.ConclusionsCalprotectin was correlated with inflammation assessed by ultrasound before and during DMARD treatment, and was also associated with radiographic progression. The data support that calprotectin may be of interest as an inflammatory marker when assessing disease activity in different stages of RA.Trial registration numberNCT01205854; Post-results.

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Treat-to-target therapy does not prevent excessive progression of carotid intima media thickness during the first year of therapy in early rheumatoid arthritis

Archives of Medical Science - Atherosclerotic Diseases ◽

10.5114/amsad.2016.60225 ◽

2016 ◽

Vol 1 ◽

pp. 42-49 ◽

Cited By ~ 2

Author(s):

Anna Raczkiewicz ◽

Aleksandra Juszkiewicz ◽

Bartłomiej Kisiel ◽

Artur Bachta ◽

Joanna Kur-Zalewska ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Early Rheumatoid Arthritis ◽

Target Therapy ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Treat To Target ◽

First Year ◽

Media Thickness

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2018 Chinese guidelines for the diagnosis and treatment of rheumatoid arthritis

Rheumatology and Immunology Research ◽

10.2478/rir-2021-0002 ◽

2021 ◽

Vol 2 (1) ◽

pp. 1-14

Author(s):

Xinping Tian ◽

Qian Wang ◽

Mengtao Li ◽

Yan Zhao ◽

Zhiyi Zhang ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Treatment Guidelines ◽

Guideline Development ◽

Diagnosis And Treatment ◽

Treat To Target ◽

Assessment Development ◽

Activity Assessment ◽

Assessment And Monitoring

Abstract A multidisciplinary guideline development group was established to formulate this evidence-based diagnosis and treatment guidelines for rheumatoid arthritis (RA) in China. The grading of recommendations, assessment, development, and evaluation (GRADE) system was used to rate the quality of the evidence and the strength of recommendations, which were derived from research articles and guided by the analysis of the benefits and harms as well as patients’ values and preferences. A total of 10 recommendations for the diagnosis and treatment of RA were developed. This new guideline covered the classification criteria, disease activity assessment and monitoring, and the role of disease modifying antirheumatic drugs (DMARDs), biologics, small molecule synthetic targeting drugs, and glucocorticoids in the treat-to-target approach of RA. This guideline is intended to serve as a tool for clinicians and patients to implement decision-making strategies and improve the practices of RA management in China.

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Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target

Frontiers in Immunology ◽

10.3389/fimmu.2021.701922 ◽

2021 ◽

Vol 12 ◽

Author(s):

Serena Bugatti ◽

Laura Bogliolo ◽

Antonio Manzo ◽

Ludovico De Stefano ◽

Paolo Delvino ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Disease Activity ◽

Bone Mineral ◽

Early Rheumatoid Arthritis ◽

Treat To Target ◽

Mineral Density ◽

Bone Mineral Density Loss ◽

Prophylactic Measures ◽

Citrullinated Protein

ObjectivesTo investigate the association of anti-citrullinated protein antibodies (ACPA) with changes in systemic bone mineral density (BMD) in patients with early rheumatoid arthritis (RA) after two years of treat-to-target.MethodsBMD was measured at the lumbar spine (LS) and femoral neck (FN) in 100 patients with recent onset RA at baseline and after 24 months of treatment aimed at low disease activity (LDA) according to the 28-joints disease activity score (DAS28 <3.2). Multivariable regression analyses were performed to determine independent associations between autoantibodies and other disease and treatment-related parameters with BMD loss.ResultsAfter 24 months, the majority of the patients were at least in LDA (78%), with slightly more ACPA-positive subjects achieving the target. The BMD had significantly decreased at both the LS (mean [SD] percent loss -1.8 [6.2], p=0.03) and the FN (-2.4 [7.3], p=0.03) in ACPA-positive but not in ACPA-negative patients. Consequently, the proportion of patients with reduced BMD (Z score ≤-1) after 24 months was significantly higher among ACPA-positive patients at both the spine (39.5% vs 19.3%, p=0.05) and the hip (37.2% vs 12.2%, p=0.007). The association between ACPA and BMD loss was independent of other variables including age, gender, disease activity, cumulative dose of glucocorticoids and duration of therapy with bisphosphonates at the LS but not the FN.ConclusionsACPA are associated with ongoing BMD loss at the spine despite suppression of inflammation and adoption of prophylactic measures. ACPA-positive RA patients should be therefore strictly monitored for the development of osteoporosis.

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