Anti-cyclic citrullinated peptide antibody in rheumatoid arthritis : Relation with disease aggressiveness

• Published in: Clinical and experimental rheumatology Vol. 24; no. 3; pp. 281 - 286
• Main Authors: DEL VAL DEL AMO, N, BOSCH, R. Ibanez, FITO MANTECA, C, GUTIERREZ POLO, R, LOZA CORTINA, E
• Format: Journal Article
• Language: English
• Published: Pisa Clinical and Experimental Rheumatology 01.05.2006
• Subjects: Arthritis, Rheumatoid - immunology; Arthritis, Rheumatoid - pathology; Arthritis, Rheumatoid - physiopathology; Arthrography; Autoantibodies - blood; Biological and medical sciences; Biomarkers - blood; Blood Sedimentation; C-Reactive Protein - analysis; Cross-Sectional Studies; Diseases of the osteoarticular system; Female; Health Status; Humans; Inflammatory joint diseases; Joints - pathology; Male; Medical sciences; Middle Aged; Peptides, Cyclic - immunology; Prognosis; Rheumatoid Factor - blood; Severity of Illness Index; Surveys and Questionnaires; Immunopathology; Prognosis; Peptides; prognostic factor; Antibody; Diseases of the osteoarticular system; Rheumatology; anti-CCP antibody; Autoimmune disease; Inflammatory joint disease; Rheumatoid factor; Chronic; Rheumatoid arthritis; Aggressiveness
• ISSN: 0392-856X; 1593-098X

To analyse the value of the anti-cyclic citrullinated peptide antibody (anti-CCP) in patients with rheumatoid arthritis (RA) as a prognostic factor, as well as its relationship with disease activity. A cross-sectional study was made on 89 patients with RA. The following values were assessed: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-CCP, Disease Activity Score 28 (DAS 28), Modified Health Assessment Questionnaire score (M-HAQ) and simplified radiologic score of Sharp/Van der Heijde (SENS: simple erosion narrowing score). Sixty-four percent of the patients were anti-CCP positive, from which 36.8% were negative for RF. Among negative RF patients, 48.3% had anti-CCP antibody. The average value of DAS 28 in anti-CCP positive patients was 4.31 (SD 1.27) compared to 3.30 (SD 1.55) for anti-CCP negative (p <or=0.001). There was a significant correlation between anti-CCP levels and CRP value (p <or= 0.011). 78.9% of anti-CCP positive patients presented erosions as opposed to a 53.1% of those with negative anti-CCP (p <or= 0.011), OR 3.3 (95% CI: 1.3-8.5). SENS in anti-CCP positive patients was significantly greater than in anti-CCP negative patients, 22.6 (SD 20.7) versus 13.88 (SD 19.24) (p <or= 0.054). Patients with high levels of anti-CCP (> 200 U/ml) had higher SENS (p < 0.05). There was no correlation between M-HAQ and anti-CCP. Prevalence of anti-CCP was higher among patients with higher activity. Patients with higher levels of anti-CCP antibody had more aggressive disease, with greater activity (elevated values in DAS 28 and CRP) and more severe radiological damage (more erosions and higher radiological damage, SENS).