Anti-CCP antibodies measured at disease onset help identify seronegative rheumatoid arthritis and predict radiological and functional outcome

[Guest guest]



1: Rheumatology (Oxford). 2005 Nov 15; [Epub ahead of print]

Anti-CCP antibodies measured at disease onset help identify

seronegative rheumatoid arthritis and predict radiological and

functional outcome.

Quinn MA, Gough AK, Green MJ, Devlin J, Hensor EM, Greenstein A,

Fraser A, Emery P.

Academic Unit of Musculoskeletal Disease, Department of Rheumatology,

Chapel Allerton Hospital, Chapeltown Road, Leeds LS74SA, UK.

Objective. Anti-cyclic citrullinated peptide (anti-CCP) antibodies

have been identified as highly specific for rheumatoid arthritis

(RA). Studies suggest an association with radiographic outcome. The

aims of this study were to assess the diagnostic and prognostic

utility of the second-generation anti-CCP2 test in a large cohort of

early RA patients compared with connective tissue disease (CTD)

controls. Methods. One hundred and eighty-two patients with RA and

121 patients with CTD were recruited. All RA patients had less than

24 months of symptoms and had CRP, rheumatoid factor (RF), HLA typing

(SE) and anti-CCP2 antibodies measured at baseline. Function was

assessed using the Health Assessment Questionnaire (HAQ) and X-rays

performed at 0, 12 and 24 months. Results. The anti-CCP2 antibody

test demonstrated a specificity of 91% and sensitivity of 81% for RA

when compared with controls. In RF-negative patients, specificity was

92% and sensitivity 60%. Baseline demographics of the RA cohort

showed mean age 57 yr, mean symptom duration 7 months, 63% RF-

positive patients, 72% SE-positive, 81% CCP-positive and 21% erosive.

The only predictor of change in Larsen score from 0 to 24 months in

the cohort was the presence of the shared epitope (P<0.05) and in the

RF-negative subgroup it was CCP2 antibody titre >100 (P<0.05).

Baseline HAQ was the only significant predictor of HAQ at 24 months,

but in the RF-negative subgroup CCP2 antibody titre >100 predicted a

poor functional response at 24 months (P<0.05). Conclusions. This

study confirms the diagnostic utility of anti-CCP2 antibodies in

early RA, particularly in seronegative patients, in whom anti-CCP2

positivity also conferred prognostic utility for radiographic and

functional outcomes.

PMID: 16287917 [PubMed - as supplied by publisher]