Research article
Serial determination of cyclic citrullinated peptide autoantibodies predicted five-year radiological outcomes in a prospective cohort of patients with early rheumatoid arthritis
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* Corresponding author: Olivier Meyer olivier.meyer@bch.aphp.fr
1 Rheumatology Unit, Assistance Publique Hôpitaux de Paris, Bichat University Hospital, 75018 Paris, France
2 Biological Immunology Department, Assistance Publique Hôpitaux de Paris, Bichat University Hospital, 75018 Paris, France
3 Rheumatology Unit B, Assistance Publique Hôpitaux de Paris, Cochin University Hospital, 75014 Paris, France
4 Rheumatology Unit, Trousseau University Hospital, 37044 Tours Cedex 1, France
5 Rheumatology Unit, Rangueil University Hospital, 31043 Toulouse Cedex 4, France
6 Rheumatology Unit, Hautepierre University Hospital, 67098 Strasbourg Cedex, France
7 Rheumatology Unit, Lapeyronie University Hospital, 34296 Montpellier Cedex 5, France
Arthritis Research & Therapy 2006, 8:R40 doi:10.1186/ar1896
Published: 26 January 2006Abstract
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.