Journal
ARTHRITIS RESEARCH & THERAPY
Volume 8, Issue 2, Pages -Publisher
BMC
DOI: 10.1186/ar1896
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The objective of this study was to evaluate the potential of serially determined anti-cyclic citrullinated peptide (CCP) antibodies for predicting structural joint damage in patients with early rheumatoid arthritis ( RA), compared to a single baseline determination. Ninety-nine RA patients with disease durations of less than one year and no history of disease-modifying antirheumatic drug therapy were followed prospectively for at least five years. Anti-CCP2 concentrations were measured using a second-generation ELISA. Sharp scores as modified by van der Heijde were determined on hand and foot radiographs. Anti-CCP2 antibodies were detected in 55.5% of patients at baseline and 63.6% at any time during the first three years. Presence of anti-CCP2 at any time during the first three years was associated with radiographic damage at baseline ( odds ratio ( OR), 3.66; 95% confidence interval ( 95% CI) 0.99 - 13.54) and with five year progression of the total Sharp score ( OR, 3.17; 95% CI, 1.3 - 7.7), erosion score ( OR, 5.3; 95% CI, 1.4 - 19.2) and joint space narrowing score ( OR, 2.8; 95% CI, 1.15 - 6.8). The presence of anti-CCP2 or IgM RF at baseline did not predict these outcomes. Patients with negative anti-CCP2 tests throughout follow-up had less radiographic progression than patients with increasing anti-CCP2 concentrations; they did not differ from patients with decreasing anti-CCP2 antibody levels. HLADRB1* typing showed that progression of the mean modified Sharp score was not correlated with the presence of the shared epitope alleles. In conclusion, serially determined anti-CCP2 antibodies during the first three years of follow-up performs better than baseline determination for predicting radiographic progression in patients with early RA.
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