RESEARCH - Antibodies to CCP and differences in clinical progression of RA

[Guest guest]

Arthritis Research & Therapy

14 June 2005

Abstract

Antibodies to citrullinated proteins (anti-cyclic-citrullinated

peptide [anti-CCP] antibodies) are highly specific for rheumatoid arthritis

(RA) and precede the onset of disease symptoms, indicating a pathogenetic

role for these antibodies in RA. We recently showed that distinct genetic

risk factors are associated with either anti-CCP-positive disease or

anti-CCP-negative disease. These data are important as they indicate that

distinct pathogenic mechanisms are underlying anti-CCP-positive disease or

anti-CCP-negative disease. Likewise, these observations raise the question

of whether anti-CCP-positive RA and anti-CCP-negative RA are clinically

different disease entities. We therefore investigated whether RA patients

with anti-CCP antibodies have a different clinical presentation and disease

course compared with patients without these autoantibodies. In a cohort of

454 incident patients with RA, 228 patients were anti-CCP-positive and 226

patients were anti-CCP-negative. The early symptoms, tender and swollen

joint count, and C-reactive protein level at inclusion, as well as the

swollen joint count and radiological destruction during 4 years of

follow-up, were compared for the two groups. There were no differences in

morning stiffness, type, location and distribution of early symptoms,

patients' rated disease activity and C-reactive protein at inclusion between

RA patients with and without anti-CCP antibodies. The mean tender and

swollen joint count for the different joints at inclusion was similar. At

follow-up, patients with anti-CCP antibodies had more swollen joints and

more severe radiological destruction. Nevertheless, the distribution of

affected joints, for swelling, bone erosions and joint space narrowing, was

similar. In conclusion, the phenotype of RA patients with or without

anti-CCP antibodies is similar with respect to clinical presentation but

differs with respect to disease course.

Full-text article:

http://arthritis-research.com/content/7/5/R949

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Mayo Clinic in Rochester

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s Hopkins Medicine

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