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. 2013 Jan 22;15(1):R16.
doi: 10.1186/ar4148.

Anti-cyclic citrullinated peptide antibody titer predicts time to rheumatoid arthritis onset in patients with undifferentiated arthritis: results from a 2-year prospective study

Nicola Bizzaro, Elena Bartoloni, Gabriella Morozzi, Stefania Manganelli, Valeria Riccieri, Paola Sabatini, Matteo Filippini, Marilina Tampoia, Antonella Afeltra, Giandomenico Sebastiani, Claudia Alpini, Vittorio Bini, Onelia Bistoni, Alessia Alunno, Roberto Gerli; Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni (FIRMA Group)

Anti-cyclic citrullinated peptide antibody titer predicts time to rheumatoid arthritis onset in patients with undifferentiated arthritis: results from a 2-year prospective study

Nicola Bizzaro et al. Arthritis Res Ther. .

Abstract

Introduction: The diagnostic, predictive and prognostic role of anti-cyclic citrullinated peptide (CCP) antibodies in rheumatoid arthritis (RA) patients is widely accepted. Moreover, detection of these antibodies in subjects presenting with undifferentiated arthritis (UA) is associated with a significant risk to develop the disease. On the other hand, clinical and prognostic significance of evaluating anti-CCP levels in subjects with inflammatory arthritis at disease onset has not been fully clarified. The goal of this prospective study is to analyze the value and prognostic significance of anti-CCP titer quantification in UA subjects.

Methods: Serial anti-CCP assays were measured in 192 consecutive patients presenting with UA lasting less than 12 weeks. Clinical and serological data and arthritis outcome were evaluated every 6 months until two years of follow-up.

Results: Anti-CCP positivity, at both low and high titer, and arthritis of hand joints significantly predicted RA at two years, risk increasing in subjects with high anti-CCP titers at baseline. Moreover, time to RA diagnosis was shorter in patients with high anti-CCP2 titers at enrollment with respect to those with low antibody concentration.

Conclusions: Presence of anti-CCP antibodies, at both low and high concentration, is significantly associated with RA development in subjects with recent onset UA. However, time interval from the onset of the first symptoms to the fulfilment of the classification criteria appears to be directly related to the initial anti-CCP level.

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Figures

Figure 1
Figure 1
Time to reach rheumatoid arthritis (RA) diagnosis according to anti-cyclic citrullinated peptide 2 (CCP2) levels in 192 patients with undifferentiated arthritis. Data were analyzed by Kaplan-Meier analysis and the log-rank test.
See this image and copyright information in PMC

References

    1. Van Venrooij W, van Beers J, Pruijn G. Anti-CCP antibodies: the past, the present and the future. Nat Rev Rheumatol. 2011;7:391–398. doi: 10.1038/nrrheum.2011.76. - DOI - PubMed
    1. Nishimura K, Sugiyama D, Kogata Y, Tsuji G, Nakazawa T, Kawano S, Saigo K, Morinobu A, Koshiba M, Kuntz KM, Kamae I, Kumagai S. Meta-analysis: Diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med. 2007;147:797–808. - PubMed
    1. Bizzaro N, Tonutti E, Tozzoli R, Villalta D. Analytical and diagnostic characteristics of 11 2nd- and 3rd-generation immunoenzymatic methods for the detection of antibodies to citrullinated proteins. Clin Chem. 2007;53:1527–1533. doi: 10.1373/clinchem.2007.087569. - DOI - PubMed
    1. van der Helm-van Mil AH, Verpoort KN, Breedveld FC, Huizinga TW, Toes RE, de Vries RR. The HLA-DRB1 shared epitope alleles are primarily a risk factor for anti-cyclic citrullinated peptide antibodies and are not and independent risk factor for development of rheumatoid arthritis. Arthritis Rheum. 2006;54:1117–1121. doi: 10.1002/art.21739. - DOI - PubMed
    1. Bartoloni E, Alunno A, Bistoni O, Bizzaro N, Migliorini P, Morozzi G, Doria A, Mathieu A, Lotzniker M, Allegri F, Riccieri V, Alpini C, Gabrielli A, Tampoia M, Gerli R. on behalf of the Forum Interdisciplinare per la Ricerca nelle Malattie Autoimmuni (FIRMA) investigators. Diagnostic value of anti-mutated citrullinated vimentin in comparison to anti-cyclic citrullinated peptide and anti-viral citrullinated peptide 2 antibodies in rheumatoid arthritis: An Italian multicentric study and review of the literature. Autoimmun Rev. 2012;11:815–820. doi: 10.1016/j.autrev.2012.02.015. - DOI - PubMed