Journal
ANNALS OF THE RHEUMATIC DISEASES
Volume 67, Issue 6, Pages 801-807Publisher
B M J PUBLISHING GROUP
DOI: 10.1136/ard.2007.076679
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Funding
- NCRR NIH HHS [K12 RR017707] Funding Source: Medline
- NIAID NIH HHS [R21 AI061479-01, K23 AI064397-01A2, R21 AI061479, R21 AI61479, K23 AI064397, R21 AI061479-02] Funding Source: Medline
- NIAMS NIH HHS [T32 AR07534, K23 AR051461-01, K23 AR051461, K23 AR051461-02, K23 AR051461-03, T32 AR007534, T32 AR007534-16, K23 AR051461-04, T32 AR007534-18, K23 AR051461-05] Funding Source: Medline
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Objectives: To investigate factors that may influence the prevalence and timing of appearance of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies during the preclinical phase of rheumatoid arthritis (RA) development. Methods: 243 serial prediagnosis serum samples from 83 subjects with RA were examined for the presence of RF and anti-CCP antibodies. Results: Of the 83 cases, 47 (57%) and 51 (61%) subjects had at least one prediagnosis sample positive for RF or anti-CCP, respectively. Gender and race were not significantly associated with the prevalence or timing of preclinical antibody appearance. Preclinical anti-CCP positivity was strongly associated with the development of erosive RA (odds ratio=4.64; 95% confidence interval 1.71 to 12.63; p<0.01), but RF was not (p=0.60). Additionally, as age at the time of diagnosis of RA increased the duration of prediagnosis antibody positivity for RF and anti-CCP increased, with the longest duration of preclinical antibody positivity seen in patients diagnosed with RA over the age of 40. In no subjects did symptom onset precede the appearance of RF or anti-CCP antibodies. Conclusions: The period of time that RF and anti-CCP are present before diagnosis lengthens as the age at the time of diagnosis of RA increases. This finding suggests that factors such as genetic risk or environmental exposure influencing the temporal relationship between the development of RA-related autoantibodies and clinically apparent disease onset may differ with age.
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