scholarly journals ASSOCIATION OF SEROLOGICAL STATUS WITH THE FREQUENCY OF CLINICAL AND RADIOLOGICAL REMISSION IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 17 (2) ◽  
pp. 59-69
Author(s):  
O.B. Iaremenko
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Factor ◽  
Clinical Remission ◽  
Serological Markers ◽  
Basic Drugs ◽  
Significant Difference ◽  
Serological Status ◽  
The Relationship ◽  
Serological Variant ◽  
Citrullinated Peptide

Relevance. Achieving remission is one of the main goals in the treatment of patients with rheumatoid arthritis (RA). One of the determining predictors of the disease, according to the literature, is the serological variant of RA. However, there are conflicting data in scientific publications on the relationship between the presence of antibodies to cyclic citrullinated peptide (ACCP) and / or rheumatoid factor (RF) and the frequency and rate of remission. There is no unanimous opinion in the literature on the influence of the titer of serological markers of RA (ACCP and RF) on the possibility of achieving remission on the background of basic treatment, which prompted to conduct their own research to study this issue. Objective: to study the relationship between the presence / absence of serological markers of RA (ACCP, RF) and the frequency and timing of clinical and radiological remission of RA under the influence of treatment with traditional synthetic basic drugs and to analyze the relationship between ACCP and RF titers and the possibility of remission.Material and methods. The study analyzed the influence of serological status of patients with RA on the possibility and time of remission while taking the main non-biological basic drugs. The relationship between the presence and level of ACCP and / or RF and clinical and radiological remission in RA has been studied. The study included 128 patients. Analysis of RA activity and assessment of remission were performed after 6, 12 and 24 months of treatment, using the DAS28 activity scale and the dynamics of radiological changes on the Sharpe-van der Heide scale. Results. During the 2-year follow-up, clinical remission was observed three times more often in the group of patients negative for ACCP (anti-cyclic citrullinated peptide) (36.1% in the group ACCP-RF- compared with 12.5% ​​in the group ACCP + RF ( +, χ2 = 7.74, p < 0.05, and in 33.3% in the group ACCP-RF +, a significant difference compared with ACCP + RF +, χ2 = 4.55, p <0.05). Early remission (during the first 6 months of treatment) was also more common in the group of patients with no ACCP (χ2 = 10.7, p <0.01 and χ2 = 6.69, p <0.05, respectively). The rate of remission (the share of early in the structure of the total) in the four analyzed groups did not differ significantly and was 75%, 66.6%, 66.6% and 84.6%, respectively. The titer of ACCP in the group of patients who achieved remission was 240.8 ± 38.5 and did not differ significantly from that in the group of patients whose RA (rheumatoid arthritis) activity exceeded the remission threshold (187.8 ± 13.7, p> 0.05). There was also no significant difference between these two groups in the titers of the RF (rheumatoid factor): 257.9 ± 233.8 and 293.2 ± 257.3, respectively. Radiological remission was achieved in 46.7% of ACCP-negative patients and only in 10.6% of ACCP-positive patients (p <0.01). The absence of RF in the blood was also associated with a more frequent achievement of radiological remission (in 34.2% of patients) compared with the RF-positive cohort of patients (in 15.4%, p <0.05). Conclusions. It was found that the frequency of clinical remission, including early (during the first 6 months of treatment), is three times higher in patients with RA, negative for ACCP. The rate of clinical remission (ratio of early in the structure of the general) does not depend on the serological variant of the disease: about two thirds of patients in all analyzed groups achieve remission in the first half of basic therapy. Titers of the main serological markers of RA (ACCP and RF) in the onset of the disease do not affect the possibility of achieving clinical and  radiological remission. Radiological remission is observed three times more often in seronegative (for ACCP or RF) patients. Double seropositivity has an additive effect on subsequent joint destruction.

Anti-carbamylated Protein Antibodies and Serum Level of 14-3-3 Protein for Early Detection of Rheumatoid Arthritis Patient in Correlation with Rheumatoid Factor, Anti-CCP Antibodies, Disease Activity and Joint Damage using High Frequency Musculoskeletal Ultrasound

2020 ◽  
Vol 7 (2) ◽  
pp. 141-153
Author(s):  
Sahar A. Ahmed ◽  
Enas M. Darwish ◽  
Walaa A. Attya ◽  
Mai Samir ◽  
Mennatallah Elsayed ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Disease Activity Score ◽  
Joint Damage ◽  
Musculoskeletal Ultrasound ◽  
Activity Score ◽  
Das 28 ◽  
Significant Difference ◽  
Hands And Feet

Background: Rheumatoid arthritis (RA) is a common progressive chronic inflammatory autoimmune disease which affects mostly small joints, causing pain, swelling, deformity, and disability. Although progress has been made in exploring RA nature, still there is a lot to know about the disease pathogenesis, diagnosis, and treatment. Aim of the Work: To investigate the role of serum anti-carbamylated protein antibodies and 14-3-3η in the diagnosis of RA compared to rheumatoid factor (RF), anti-CCP antibodies, and highfrequency musculoskeletal ultrasound used to assess the disease activity and joint damage. Methods: Serum anti-carbamylated protein antibodies and 14-3-3η were measured using ELISA in 61 RA patients and 26 normal controls. RA Disease Activity Score (DAS 28), X-ray and musculoskeletal ultrasound (hands and feet), carotid ultrasound (Intima-Media Thickness IMT) were used in assessing the RA disease. Results: Anti-carbamylated protein antibodies were significantly elevated in RA patients 4.5 (4.1- 8.9 U⁄ml) compared to the control 3.2(1.9- 4.3 U⁄ml) (p< 0.001) but 14-3-3η showed no significant difference. There was a significant positive correlation between anti-carbamylated protein antibodies, 14-3-3η levels and disease activity score assessed by DAS 28, increased IMT measured by carotid duplex, total synovitis and total erosion score were assessed by musculoskeletal ultrasound. There was no correlation between RF and anti-CCP antibodies. Anti-carbamylated protein antibodies were found to have 66.7% sensitivity and 85.2% specificity in RA diagnosis, while 14- 3-3η had 51.9% sensitivity and 72.1% specificity. Conclusion: Anti-carbamylated protein antibodies and 14-3-3η have a high sensitivity and specificity in RA diagnosis and had a correlation with the disease activity and joint damage.

scholarly journals POS0495 LARGE JOINT DISEASE IN RHEUMATOID ARTHRITIS AND THE ROLE OF RHEUMATOID FACTOR. RESULTS FROM THE EARLY RHEUMATOID ARTHRITIS STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 480-480
Author(s):  
S. S. Zhao ◽  
E. Nikiphorou ◽  
A. Young ◽  
P. Kiely
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Factor ◽  
Treatment Strategies ◽  
Treat To Target ◽  
Joint Involvement ◽  
Aggressive Treatment ◽  
Joint Surgery ◽  
Large Joint ◽  
Significant Difference ◽  
Over Time

Background:Rheumatoid arthritis (RA) is classically described as a symmetric small joint polyarthritis with additional involvement of large joints. There is a paucity of information concerning the time course of damage in large joints, such as shoulder, elbow, hip, knee and ankle, from early to established RA, or of the influence of Rheumatoid Factor (RF) status. There is a historic perception that patients who do not have RF follow a milder less destructive course, which might promote less aggressive treatment strategies in RF-negative patients. The historic nature of the Ealy Rheumatoid Arthritis Study (ERAS) provides a unique opportunity to study RA in the context of less aggressive treatment strategies.Objectives:To examine the progression of large joint involvement from early to established RA in terms of range of movement (ROM) and time to joint surgery, according to the presence of RF.Methods:ERAS was a multi-centre inception cohort of newly diagnosed RA patients (<2 years disease duration, csDMARD naive), recruited from 1985-2001 with yearly follow-up for up to 25 (median 10) years. First line treatment was csDMARD monotherapy with/without steroids, favouring sulphasalazine for the majority. Outcome data was recorded at baseline, at 12 months and then once yearly. Patients were deemed RF negative if all repeated assessments were negative. ROM of individual shoulder, elbow, wrist, hip, knee, ankle and hindfeet joints was collected at 3, 5, 9 and 12-15 years. The rate of progression from normal to any loss of ROM, from years 3 to 14 was modelled using GEE, adjusting for confounders. Radiographs of wrists taken at years 0, 1, 2, 3, 5, 7, 9 were scored according to the Larsen method. Change in the Larsen wrist damage score was modelled using GEE as a continuous variable, while the erosion score was dichotomised into present/absent. Surgical procedure data were obtained by linking to Hospital Episodes Statistics and the National Joint Registry. Time to joint surgery was analysed using multivariable Cox models.Results:A total of 1458 patients from the ERAS cohort were included (66% female, mean age 55 years) and 74% were RF-positive. The prevalence of any loss of ROM, from year 3 through to 14 was highest in the wrist followed by ankle, knee, elbow and hip. The proportion of patients at year 9 with greater than 25% loss of ROM was: wrist 30%, ankle 12%, elbow 7%, knee 7% and hip 5%. Odds of loss of ROM increased over time in all joint regions, at around 7 to 13% per year from year 3 to 14. There was no significant difference between RF-positive and RF-negative patients (see Figure 1). Larsen erosion and damage scores at the wrists progressed in all patients; annual odds of developing any erosions were higher in RF-positives OR 1.28 (95%CI 1.24-1.32) than RF-negatives OR 1.17 (95%CI 1.09-1.26), p 0.013. Time to surgery was similar according to RF-status for the wrist and ankle, but RF-positive cases had a lower hazard of surgery at the elbow (HR 0.37, 0.15-0.90), hip (HR 0.69, 0.48-0.99) and after 10 years at the knee (HR 0.41, 0.25-0.68). Adjustment of the models for Lawrence assessed osteoarthritis of hand and feet radiographs did not influence these results.Figure 1.Odds of progression to any loss of ROM (from no loss of ROM) per year in the overall population and stratified by RF status.Conclusion:Large joints become progressively involved in RA, most frequently affecting the wrist followed by ankle, which is overlooked in some composite disease activity indices. We confirm a higher burden of erosions and damage at the wrists in RF-positive patients, but have not found RF-negative patients to have a better prognosis over time with respect to involvement of other large joints. In contrast RF-negative patients had more joint surgery at the elbow, hip, and knee after 10 years. There is no justification to adopt a less aggressive treatment strategy for RF-negative RA. High vigilance and treat-to-target approaches should be followed irrespective of RF status.Disclosure of Interests:None declared

scholarly journals TO ASSESS THE SENSITIVITY AND SPECIFICITY OF SERUM ANTICYCLIC CITRULLINATED PEPTIDE ANTIBODY IN PATIENTS WITH RHEUMATOID ARTHRITIS IN A COMMUNITY HOSPITAL IN LAHORE, PAKISTAN

1969 ◽  
Vol 4 (2) ◽  
pp. 503-507
Author(s):  
BUSHRA GOHAR SHAH ◽  
HAMID JAVAID QURESHI ◽  
IZAZ UR REHMAN
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Factor ◽  
Sensitivity And Specificity ◽  
Cell Biology ◽  
Venous Blood ◽  
Research Work ◽  
Specific Marker ◽  
Cross Sectional ◽  
Peptide Antibody ◽  
Citrullinated Peptide

OBJECTIVES: To compare the sensitivity and specificity of serum anti-Cyclic Citrullinated Peptideantibody (anti-CCP) with serum rheumatoid factor in diagnosing rheumatoid arthritis (RA) in acommunity hospital in Lahore, Pakistan.DESIGN: Cross-sectional analytical study.PLACE & DURATION OF STUDY: Subjects were recruited from Fatima Memorial Hospital,Rheumatology Outpatient Department from January, 2010 to December, 2010. The research work wasconducted at Department of Physiology and Cell Biology of University of Health Sciences, Lahore.SUBJECTS & METHODS: Eighty diagnosed patients of rheumatoid arthritis and thirty normalhealthy controls were included in the study. After selection of subjects, written informed consent wasobtained. The venous blood sample was taken and secured in vacutainers. Serum was extracted bycentrifugation and stored at -20°C till analysis. Titers of anti-CCP and rheumatoid factor weredetermined by ELISA. The data obtained was analyzed by using SPSS version 16.0.RESULTS: The sensitivity and specificity of serum anti-CCP was found to be 58.6% and 86.7%respectively as compared to 47.5% and 83.3% for serum rheumatoid factor (RF) in diagnosingrheumatoid arthritis. Sensitivity of anti-CCP antibody in RF negative sub-group was 32.1%.CONCLUSION: Serum anti-CCP antibody is more sensitive and specific marker for diagnosis ofrheumatoid arthritis as compared to the rheumatoid factor.KEY WORDS: Rheumatoid Arthritis, Anti- Cyclic Citrullinated Peptide Antibody (ACCP), Rheumatoid Factor

scholarly journals The Relationship Between Hyperglycemia and the Rheumatoid Factor in the Serum of Diabetic Patients

2009 ◽  
Vol 6 (1) ◽  
pp. 99-105
Author(s):  
Baghdad Science Journal
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Factor ◽  
Healthy Subjects ◽  
Diabetic Patients ◽  
Diabetic Mellitus ◽  
Positive Rheumatoid Factor ◽  
Common Diseases ◽  
Males And Females ◽  
The Relationship ◽  
Apparently Healthy

This study was conducted to determine the relationship between two most common diseases in Iraqis patients , which are Diabetic mellitus (DM) and Rheumatoid Arthritis (RA); seeking rheumatoid factor in hyperglycemic sera. The results revealed that ; 62.5% of hyperglycemic (HG) patients had positive rheumatoid factor (RF) . No difference in number between both gender of HG patients (20 males and 20 females ) , RF reaction was nearly similar in males and females of HG patients ( 12 &13 respectively ) . Only 40% out of patient controls had positive RF . None of the apparently healthy subjects had positive RF .

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